Summary

The Texas Alliance of Child and Family Services (TACFS) is the network of community organizations that provide services to children, youth, and families involved, or at risk of being involved, with the child welfare system. Our members contract with the Department of Family and Protective Services (DFPS) to provide direct care to prevent neglect or abuse, heal trauma when abuse occurs, achieve permanency for children in care, and improve long-term outcomes for all children and youth in communities across Texas.

Investment is needed to support and work toward positive outcomes for children in foster care. For every child that enters foster care, around 20 percent are likely to have system reinvolvement within one year after exiting care. That number jumps to nearly 40 percent within five years. At every opportunity we have to interact with children and families across the continuum, there is an obligation to “get it right” the first time.

This proposal is reflective of the sense of urgency felt statewide, in the legacy and Community Based Care systems, to stabilize and grow capacity. The additional and compounding pressures on the system with COVID-19, federal foster care lawsuit, increasing costs and stressors, and, most recently, the winter storm and resulting utility outages have left foster care providers and the children, youth, and families they serve in need of additional support.

TACFS recommends full funding of foster care rates based on the rate schedule released by the Health and Human Services Commission in January 2021 for a total investment of an additional $91,059,596 ($72,043,307 in state funds) for the 2022/2023 biennium.

It is important to note that the data produced by the State to reflect the “full cost of care” is based on cost reports that are several years old and do not reflect any cost-of-living adjustments and other factors such as increased costs related to COVID-19 and other external drivers discussed in this report. The investment into foster care directly impacts the quality and capacity of the services available to children, youth, and families. We believe this investment will better support the entire continuum of care and meet our state’s most critical capacity needs.

Current Capacity Needs

Texas’ system is struggling to grow and maintain vital capacity. After a spike in new entries into foster care in 2018, that number of needed foster care placements has been declining, with a significant drop in 2020, likely due to the COVID-19 pandemic.

The data shows new entries to care have slowed over FY19 to FY21 (to date) when compared to FY16 to FY18.

Despite decreases of new entries into care, however, we have not seen decreases in demand for placements. In fact, the data also shows that the overall number of children in care has remained constant or increased slightly.

External Capacity Drivers

COVID-19. Since the onset of the COVID-19 pandemic, child welfare work became more complex and held a growing sense of urgency. Child-serving organizations had to re-evaluate how they serve children, families, and staff to protect everyone involved in the work. For an entire year, these organizations managed in this capacity while making the necessary investments to provide necessary equipment to ensure the safety and well-being of everyone in the organization. However, these investments were not budgeted in the fiscal year budget. Many organizations are struggling to continue to provide the same quality services with the onset of these expenses. TACFS estimates organizations are spending an additional $20,000 -$40,000 a month.These expenses are a result of some of the following needs:

  • Major unanticipated staffing costs for schools closing and other workforce stressors.
  • Technology needs for virtual visitation, telemedicine, and virtual schooling.
  • Need for personal protective equipment for children, caregivers, and staff.

Federal Foster Care Lawsuit. In the implementation process of the decade long lawsuit, child-serving organizations are facing system changes that, although they provide transparent accountability, are forcing organizations to redirect resources into administration costs rather than investing into children and services. The lawsuit orders require increased scrutiny on violations, citations, and investigations and organizations are working diligently to stay in compliance. Additionally, there is significant concern that this will negatively impact the ability to place children with more complex needs and challenging behaviors such as running away, aggression, or self-harming. Texas has the unique opportunity to build public confidence in the child welfare system. However, in order to build public confidence, we must eliminate agency silos and duplicative oversight to provide clear oversight and invest resources in the lawsuit that will be directed toward the care and services of children and families.

Federal Foster Care Lawsuit. In the implementation process of the decade long lawsuit, child-serving organizations are facing system changes that, although they provide transparent accountability, are forcing organizations to redirect resources into administration costs rather than investing into children and services. The lawsuit orders require increased scrutiny on violations, citations, and investigations and organizations are working diligently to stay in compliance. Additionally, there is significant concern that this will negatively impact the ability to place children with more complex needs and challenging behaviors such as running away, aggression, or self-harming. Texas has the unique opportunity to build public confidence in the child welfare system. However, in order to build public confidence, we must eliminate agency silos and duplicative oversight to provide clear oversight and invest resources in the lawsuit that will be directed toward the care and services of children and families.

Family First Prevention Services Act (FFPSA). This federal law goes into effect in the fall of 2021. The opportunity to draw down federal IV-E funds highlights the need for states to serve the most vulnerable children in residential settings while increasing the capacity for foster homes. Serving high needs children in family settings requires special foster families with a unique skillset, intense training, and ongoing support. In order for FFPSA to succeed, the state must provide a clear direction to develop high quality placements for children with complex needs.

Increasing Costs: With the developing changes in the child welfare environment to adopt new therapy and methods of care, and analyze and interpret new data, administration costs consistently increase year to year.

Quality Workforce to Support Capacity Needs

“A well-trained, highly skilled, well-resourced and appropriately deployed workforce is foundational to a child welfare agency’s ability to achieve best outcomes for the vulnerable children, youth, and families it serves.” – Casey Family Programs

Just as with the DFPS Child Protective Services (CPS) workforce, an experienced, trained, and stable workforce at Child Placing Agencies (CPAs) and General Residential Operations (GROs) is associated with positive outcomes for children and families. Research shows a strong and tenured workforce is critical to high quality case decision-making and family engagement. Reduced turnover of child welfare staff also results in improved outcomes through:

  • More frequent contacts with children and families.
  • Reduced number of placements (linked to improved permanency outcomes for children).

Update Rate Methodology

The recently released Texas Health and Human Services Foster Care Rate Methodology Study conducted by the Public Consulting Group (PCG) offers a stark picture of an outdated funding structure. At a high level, the study says that:

  •  The current rates do not clearly align to cost of care.
  • The current rate level system, whereby rates can fluctuate for children based on assessed service level, creates fiscal challenges.
  • The rate development process is primarily retrospective.
  • The rate calculations mix retrospective costs with forecasted placements.
  • There is overreliance on fundraising to support contract requirements.

Capacity Building Strategies

The following strategies are recommended in addition to funding foster care provider rates. These strategies will further support maintaining and growing capacity.

1. Provide incentive or additional funding for organizations that support children with complex needs (such as behavioral health issues, sex trafficking survivors, and pregnant and parenting youth). Consider funding to support high quality providers that take placements with complex needs. This payment could support additional therapeutic support, wraparound services, training needs, and more.

2. Direct state agencies to streamline the credentialing process for child-serving organizations to be credentialed as Senate Bill 58 providers to offer a full array of Medicaid behavioral health services. According to the American Academy of Pediatrics (AAP), up to 80 percent of children in foster care enter with a significant mental health need. Failure to address the behavioral health needs of children in foster care can result in poor permanency outcomes for children and costly outcomes for the state. Supporting these services will work toward improving outcomes for kids and provide improved stability in placements.

3. Fully fund the direct care workforce component of rates. Texas has heavily invested in improving the quality and retention of CPS staff, which has created a lack of parity in salaries compared to those offered by CPAs and GROs. Just as with the CPS workforce, an experienced, trained, and stable workforce at CPAs and GROs is associated with positive outcomes for children and families. Reduced turnover results in more contacts/visits with children and families, better service delivery, and improved safety, permanency, and well-being. Quality investments in the foster care direct care workforce to ensure a stable workforce and positive outcomes for children and families. A quality, effective workforce will, in turn, lead to better coordination and integration of services, more efficient use of public funds, and, most importantly, positive outcomes for children, youth, and families.

Federal Funding Strategies

FFPSA. Texas has started compliance through a small group piloting Qualified Residential Treatment Programs. Continuing to grow and support this program, while gathering data and costs will support the Legislature’s future decisions for residential treatment programs. Although the implementation is complex, maximizing federal funding through FFPSA will support Texas in developing a robust array of services. In addition, Texas can continue to grow federally funded program models that serve populations such as pregnant and parenting youth and trafficking survivors, which are critical to keeping high-risk populations stable.

Older and aging out youth. In December, Congress passed the Consolidated Appropriations Act (HR 133)1, Division X, Supporting Foster Youth & Families through the Pandemic Act. Texas was allocated $400 million, with a minimum $50 million set aside for education tuition voucher (ETV). It is estimated this will allocate around $25 million in federal Chafee funding and, at minimum, $6 million for ETV funding to Texas. This act requires that states continue to ensure that the safety, permanence, and well-being needs of older foster youth, including young adults in extended/return to care, continue to be met, as well as meaningful transition planning for young adults in extended foster care. It authorizes states to use any of the money they receive under additional Chafee funding to support these purposes.

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