Contractors cutting number served in child welfare

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October 31, 2011 - 7:00pm

Two private contractors involved with Nebraska's child welfare reform are trying to cut the number of children they serve by 15 percent. The Department of Health and Human Services approves, saying that's part of the effort to bring about long-needed changes. But some people watching the reforms have questions.

If you look at a graph of the number of children served this year in Douglas and Sarpy Counties, it's a little like a Nebraska ski slope. The drop isn't dramatic, but it's there.

From late June to mid-October, the number of children served declined by about 200, or around 5 percent.

TOTAL CHILDREN SERVED BY CONTRACTORS

Department of Health and Human Services

Children served in Douglas and Sarpy Counties. NFC numbers include children served by HHS being transitioned to NFC. Click on the graph for a larger image. For the figures behind the graph, click here.

If the 15 percent goal is reached in all the areas served by private contractors, that would mean around 1,000 fewer kids in the system.


Vicki Maca
DHHS


The decline is no accident according to Vicki Maca, head of the child welfare reform efforts in eastern and southeast Nebraska for the Department of Health and Human Services. "One of the overarching goals of Families Matter, our reform effort, is to safely reduce the number of children involved in our system," Maca said.

Part of that goal is to lower how many children are removed from their homes. While no one disputes there are cases where children must be removed for their safety, the Annie E. Casey Foundation, which advocates for disadvantaged children, says Nebraska removes children more often than any other state, at a rate twice the national average. That's a little misleading, officials say, because unlike most states, Nebraska counts children removed for committing crimes in its total. But even without that, Maca thinks the state's rate would still be high.


Stephanie Anderson
DHHS


Now, that's beginning to change, at least in the Omaha area. State workers are still responsible for initial assessments of allegations of abuse or neglect. But since early this year, they've been working in some cases with private contractors to provide an initial response that avoids getting kids into the child welfare system.

Stephanie Anderson, an initial assessment supervisor with Health and Human Services, described one late-night incident when police went out on a call and decided to remove children from a trailer because there was no heat. "An on-call worker went out and talked to the police and had called and got the contractors out. And we talked the police out of removing the kids and took the whole family out and put them in a hotel for the weekend til they could get the heat turned on," she said.

That result avoided separating the kids from their mother, getting the courts and lawyers involved, and possibly turning the kids into state wards. Lincoln state Sen. Kathy Campbell agrees removals should occur less frequently. But Campbell, who chairs the Legislature's Health and Human Services Committee, which is investigating child welfare reform, wonders about the goal of reducing the total number of kids served. "Is the goal to reduce the number of state wards? I think we all would tend to agree with that - to reduce out of home placements and perhaps provide services at home," Campbell said. "But we don't seem to have a clarity yet as to what really is an over-arching strategy and plan here, and goal."


Sen. Kathy Campbell
Chair, Health and Human Services Committee


Sandra Gasca-Gonzalez
KVC


But the goal is clear to Sandra Gasca-Gonzalez, president of KVC Behavioral Healthcare Nebraska, one of two private agencies managing child welfare cases in the Omaha area. "We look at total number of children served, in-home and out-of -home. That's how we define it - how KVC defines it," she said. Asked if the goal is to reduce that total number by 15 percent, Gasca-Gonzalez said "Yes."

Campbell says she hadn't heard that until the committee got a report from the legislative fiscal analyst's office a couple of weeks ago. "That came as somewhat of a surprise, at least it did to me, thinking Ah. When did we go to the goal of 15 percent?' (I'm) not sure that had been articulated to the committee until we listened to the budget and fiscal office of the Legislature talk to us and say "Well, that is now the goal," said Campbell.

After talking to the contractors in early October, the fiscal analysts reported Oct. 18 that significant changes are needed, including a roughly 15 percent reduction in children served, if contractors are to operate within the amounts allocated to spend this year. Those amounts are about $57 million for KVC and $33 million for the Nebraska Families Collaborative or NFC.

Gasca-Gonzalez says the contractors weren't trying to keep the committee in the dark about the 15 percent reduction. "No one's ever asked me How did you get to your budget projections?' And the first time they did ask, I provided that information. It's not because we were withholding information not from our perspective were we doing that," she said.

Campbell said child welfare reform shouldn't be driven by budget numbers or the reduction in caseloads needed to meet them. "The outcome measures should be driving this, not just a sheer percentage number," she said.

Among those measures, Campbell said, are how quickly children move to a permanent safe home. Gasca-Gonzalez agrees. She says adoptions have increased by 9 percent in KVC's southeast Nebraska service area. But she said it hurts that goal if the system is clogged with kids who don't belong in it, like one who was recently referred after being bitten by a dog. "Nebraska is 48th in the nation in meeting outcomes for permanency, safety and well-being for children and families. We don't like the idea of being next to last. And we want to improve that. And part of improving that is making sure that we have the right children who are unsafe in the system that we're serving," she said.


Georgie Scurfield
Chair, Foster Care Review Board


So are the changes, including cutting the number of kids being served in the system, making things better? "I think overall it's a good thing," said Georgie Scurfield, chairwoman of the Foster Care Review Board, which tracks the number of kids in the system and reviews cases. "But we're not sure yet because it's early days," Scurfield added. "If we have some of these children who have not been removed come into the system at a later date because we have not been able to support the families we may yet see evidence that this is not a good thing. We might have done a better job in the first place."

Scurfield says it should be easier to tell in a year or so. Meanwhile, Campbell's committee is scheduled to issue a report December 15 and is expected to propose legislation to shape the reform early next year.Correction, 11-01-11: The audio version of this story said Vicki Maca heads the child welfare reform effort for the state. She actually heads it just for the eastern and southeast service areas where the state contracts with private agencies to manage the program."

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