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IV-E Waiver Cost Analysis
#1 - How are IV-E Waiver dollars being spent?
• Goals: To track the money being allocated to each county by funding steam (e.g., EBPs vs. Family Support), to describe the goods and services provided, and to indicate the # of clients served
• How? The Evaluation Team is working with DHR to develop a detailed spreadsheet that will be completed on a regular basis by each of the 24 Maryland jurisdictions.
#2 - How have DHR’s costs shifted with the implementation of the Waiver?
• Goal: To determine whether the flexibility afforded to DHR by the Waiver has resulted in reduced administrative costs and to evaluate whether out-of-home costs decline during the Demonstration period
• How? The Evaluation Team will work with DHR to identify and track major funding sources (e.g., Title IV-E, TANF, Title IV-B, etc.) used to pay for child welfare activities and to further break down each funding source into its cost components (e.g., administration and maintenance, training). Trends over time will be examined.
#3 – What is the net benefit/cost of implementing EBPs under the IV-Waiver?
• Goal: To determine whether the costs associated with EBPs are offset by their associated benefits, such as reduced costs associated with out-of-home placements
• How? Program costs related to personnel, facilities (e.g., rent), supplies, etc. will be collected from EBP providers on a semi-annual basis. For up to three EBPs, cost-benefit analyses will be conducted, with non-EBP youth in the same county serving as comparisons. Costs associated with non-EBP placements will be obtained from DHR.
#4 – How does implementation of EBPs affect Medicaid costs?
• Goals: To assess 1) whether MA claims for were reduced for youth following their participation in EBPs, and 2) whether MA claims for EBP participants are lower than those placed in out-of-home care.
• How? Analyses will depend on the full implementation of EBPs and the availability of Medicaid claims data. Analyses will be conducted in future evaluation years.
Maryland State-wide Indicators
State Fiscal Years 2013-16
State-wide Indicators
Throughout the Waiver implementation, several state-level indicators will be monitored to assess any changes from historical trends prior to the Waiver and during Waiver implementation
The following presents rates of reunification, adoption, and guardianship; placement stability; length of stay of removal; response track; and residential placements from SFY’s 2013-15 (pre-Waiver) and 2016 (first year of Waiver implementation)
Response Track
0%
20%
40%
60%
80%
100%
SFY 13(N=40,595)
SFY 14(N=36,034)
SFY 15(N=31,944)
SFY 16(N=30,817)
AlternativeResponse
InvestigativeResponse
Pre-Waiver Waiver
Other Statewide Indicators
0%
20%
40%
60%
80%
100%
SFY 13(N=3,218)
SFY 14(N=3,016)
SFY 15(N=2,633)
SFY 16(N=2,486)
Reunification Adoption Guardianship
Pre-Waiver Waiver
Exit
s fr
om
OO
HP
4.6 4.2 4.2 4.5
0.01.02.03.04.05.06.07.08.0
FY13(N=2,532)
FY14(N=2,401)
FY15(N=2,185)
FY16(N=2,480)
Moves per 1,000 Days in Care
Pre-Waiver Waiver
136 130 128 132
0
50
100
150
200
250
FY13(N=2,532)
FY14(N=2,401)
FY15(N=2,185)
FY16(N=2,480)
Average Days Removed
Pre-Waiver Waiver
5.6% 4.4%
6.2% 6.5%
1.3% 1.5% 1.9% 1.8%
0%
2%
4%
6%
8%
10%
FY13(N=2,533)
FY14(N=2,421)
FY15(N=2,195)
FY16(N=2,491)
Community Residential Non-Community Residential
Entr
ie
Pre-Waiver Waiver
Rates of Reunification, Adoption, & Guardianship Placement Stability
Length of Stay of Removals Residential Placements
How to Contact Us:
Bethany Lee, PhD Evaluation Director
Pam Freeman, PhD Lead Evaluator for CANS-F/ Trauma
Elizabeth Greeno, PhD Lead Evaluator for EBPs [email protected]
John Cosgrove Senior Data Analyst
Rochon Steward Research Specialist
Maria Jose Horen Research Supervisor
Sara Betsinger, PhD Lead Cost Evaluator
David Chen Senior Data Analyst