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Department of Health and Human Services&
Department of ProbationOctober 28, 2014
Title IV-E California Well-Being Project
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Objective
• To test child welfare interventions designed to decrease reliance on foster care and shorten the time children have open welfare cases.
Goals
• Improve permanency and well-being outcomes• Increase child safety without over reliance in out-of-home care• Improve service array• Engage families through individualized case work
October 28, 2014 DHHS & Probation–Title IV-E Waiver 2
California Well-Being Project
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Cohort 17/1/07 – 9/30/19
Alameda
Los Angeles
Cohort 210/1/14 – 9/30/19
Butte
Lake
Sacramento
San Diego
San Francisco
Santa Clara
Sonoma
October 28, 2014 DHHS & Probation–Title IV-E Waiver 3
Participating Counties
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Flexible use of federal foster care funding
Must include child welfare and probation – DHA in Sacramento County
Capped funding allocation based on 5-year average (2008-2012)
Requires maintenance of base spending level
October 28, 2014 DHHS & Probation–Title IV-E Waiver 4
How Does It Work?
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Counties must implement prevention and family centered practices
Requires reinvestment of savings into child welfare and probation Well-Being Project activities
The evaluation component will include process, outcomes and costs
Counties may opt out with fiscal repercussions
October 28, 2014 DHHS & Probation–Title IV-E Waiver 5
How Does It Work? (continued)
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Federal Funds
$49.5 M
Local Share
$107.1 M
$156.6 million
October 28, 2014 DHHS & Probation – Title IV-E Waiver 6
Estimated Full Year Budget Comparison
Federal Funds
$66.3 M
Local Share
$107.1 M
$173.4million
No Waiver
Waiver
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Additional federal funds
(waiver)
Base amount
(five-year average)
Unchanged local
spending
Increased
Investment in Better Outcomes
October 28, 2014 DHHS & Probation – Title IV-E Waiver 7
How Are Savings Generated?
Increased Investment in
Better Outcomes
Decreased number of children in
out-of-home care
Reduced entries and re-entries
SAVINGS
Increased Budget
Lower Expenditures
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• $12.3 million in flexible federal funding for FY 14/15
• Annualized $16.7 million through FY 18/19 (plus inflator)
Increased federal funding
• Prevention• Wrap-around• Intensive family reunification• Evidence-based programs
Use of flexible dollars and reinvestment of future
savings into programs…
• Increased reunification for CPS children• More timely permanency for foster children• Reduced re-entries into CPS• Reduced recidivism for Probation children• Reduced entry into systems due to effective
prevention
…for better outcomes
October 28, 2014 DHHS & Probation – Title IV-E Waiver 8
Potential Benefits to Sacramento County
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If total costs in a given year exceed the level of additional funding, the County will be required to absorb those excess costs with local funding
DHHS & Probation – Title IV-E Waiver 9
What is the Risk?
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Caseloads Placement Costs Operation/Admin Costs
Realignment Growth
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Variables Affecting Level of County Risk
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Length Of StaysEntries & Reentries
Group Home PlacementsOut-of-County PlacementsOut-of-State Placements
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High Risk Scenarios
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DHHS & Probation – Title IV-E Waiver 12
Preliminary Plan for Use of IV-E Waiver (Full Year)
October 28, 2014
Department Positions (FTEs)
Full Year Staff
Costs*
Contracts* Total*
DHHS 24 $2.6 $7.5 $10.1
Probation 12 $1.5 $2.7 $4.2
DHA 2 $0.3 __ $0.3
Subtotal 38 $4.4 $10.2 $14.6
Aid Payments $2.0
TOTAL 38 $4.4 $10.2 $16.6*millions
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Mitigating risk
• Funds set aside to cover unforeseen cost increases
Early opt out costs
• County would have to pay back all waiver money spent on services that are not Title IV-E eligible under traditional funding structure
Sustainability
• How would County fund waiver-related programs after the waiver period (FY19-20)?
October 28, 2014 DHHS & Probation – Title IV-E Waiver 13
Other Considerations
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October 28, 2014 DHHS & Probation – Title IV-E Waiver 14
QUESTIONS
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Michelle Callejas Deputy Director
Child Protective Services
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Achieving Better Outcomes
Increased SafetyPrevention of Abuse
and Neglect
More Timely and Successful
Permanency
DHHS & Probation – Title IV-E Waiver
Title IV-E California Well-Being Project
October 28, 201416
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DHHS & Probation – Title IV-E Waiver
Planned Interventions
October 28, 201417
Safety• Safety
Organized Practice (SOP)
Prevention• Focus on
children 6 and older
Permanency• Intensive Family
Finding and Kinship Support
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DHHS & Probation – Title IV-E Waiver
Planned Interventions (continued)
October 28, 201418
Safety• SOP is
engagement model
• Similar to Signs of Safety
Prevention• Expanding
services in Family Resource Centers
Permanency• Competitive
process• Letters of
Interest (LOI)• RFP
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Providers
• Contracting for permanency and prevention services
• $1.1 million for FY 14-15• $36 million over 5 years
Staff• Partnering with providers to achieve
outcomes• Support local and state evaluation efforts• Support policy development and training• Ensure compliance with CWS/CMS
requirements
DHHS & Probation – Title IV-E Waiver 19
Building Capacity
October 28, 2014
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DHHS & Probation – Title IV-E Waiver
Focus on Outcomes
October 28, 201420
Continuous Quality Improvement
Prevention
Permanency
Safety
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If chosen interventions do not lead to expected outcome improvements then we will not continue investing in them
DHHS & Probation – Title IV-E Waiver 21
Monitoring is Key
October 28, 2014
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Year 1- Stable
Year 2 – 5% (ages 0-18)
Year 3 – 4% (ages 0-18)
Year 4 – 2% (ages 0-18)
Year 5 – 2% (ages 0-18)
DHHS & Probation – Title IV-E Waiver 22
Projected Caseload Reductions
October 28, 2014
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$7 Million Over 5 years
DHHS & Probation – Title IV-E Waiver 23
Anticipated Savings
October 28, 2014
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DHHS & Probation – Title IV-E Waiver 24
Possible Risks
October 28, 2014
Jul-07 Jul-08 Jul-09 Jul-10 Jul-11 Jul-12 Jul-13 Jul-14
Sacramento 4142 3880 3877 3191 2701 2260 2214 2471
250750
1250175022502750325037504250
Sacramento In Care - Ages 0 - 17 Child Wel-fare
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DHHS & Probation – Title IV-E Waiver 25
Possible Risks
October 28, 2014
JUL 05 - JUN 06
JUL 06 - JUN 07
JUL 07 - JUN 08
JUL 08 - JUN 09
JUL 09 - JUN 10
JUL 10 - JUN 11
JUL 11 - JUN 12
JUL 12 - JUN 13
JUL 13 - JUN 14
Sacra-mento
2642 2367 2011 2441 1317 1229 1176 1359 1781
250
750
1,250
1,750
2,250
2,750
Sacramento Children Entering Care Age 0-17 Child Welfare
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October 28, 2014 DHHS & Probation – Title IV-E Waiver 26
QUESTIONS
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Brian LeeDivision Chief
Probation
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Achieving Better Outcomes
Decreased Entries Reduced Recidivism Prevent Delinquency
DHHS & Probation – Title IV-E Waiver
Title IV-E California Well-Being Project
October 28, 201428
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DHHS & Probation – Title IV-E Waiver
Planned Interventions
October 28, 201429
Entries• Wraparound
Services (WRAP)
Recidivism• MultiSystemic
Therapy (MST)
Prevention• Functional
Family Therapy (FFT)
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Providers
• $11.7 million over five years
Staff• Assist with outcome, audit and service
delivery• Cross-over youth practice model and other
cross-systems initiatives• Case management and supervision
DHHS & Probation – Title IV-E Waiver 30
Building Capacity
October 28, 2014
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25% reduction
Decreased time in out-of-home placement
DHHS & Probation – Title IV-E Waiver 31
Projected Caseload Reductions
October 28, 2014
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October 28, 2014 DHHS & Probation – Title IV-E Waiver 32
QUESTIONS