Review of Legislative Finance Committee (LFC) Child Welfare Analysis - PowerPoint PPT Presentation

Review of Legislative Finance Committee (LFC) Child Welfare Analysis and Recommendations Jon Courtney, Program Evaluation Manager Kelly Klundt, Fiscal Analyst October 10, 2018 1

Presentation Overview  Summary of trends, spending and current situation  Description of relevant programs impacting child welfare outcomes and recommendations  Q&A 2

NM Child Welfare System Facts: New Mexico ◦ $107 thousand : The average cost per child of a Child case of maltreatment resulting in adoption in Maltreatment New Mexico ◦ New Mexico’s child victimization rate is significantly higher than the national average • Child welfare involvement is ◦ New Mexico’s children have more adverse costly. childhood experiences than children in most • The system is becoming other states more costly as child ◦ Rates of drug abuse and alcohol abuse for maltreatment rates climbed 28% over the last 5 years. caregivers are more than double the national averages highlighting the need for prevention • NM families have a number of risk factors that could be and intervention addressed through preventative services. 3

Although new opportunities are arising, the use of federal funds for prevention is not new Families First Prevention Services Act ◦ Opens up IV-E dollars to be used on prevention services (currently $68 million ($43 million federal)) used for foster care and adoption in NM) ◦ Seeks to decrease the use of group homes (aka congregate care) Opportunities have existed for years to fund prevention services via: ◦ Title I of the Child Abuse Prevention and Treatment Act (CAPTA) ◦ Title II of CAPTA ◦ Title IV-B ◦ Social Services Block Grant Funding (SSBG) CYFD’s Protective Services reports delivering fewer prevention services than almost every other state in the nation. ◦ Preventative services per 1,000 in FY16 (Source: ACF Child Maltreatment 2016) ◦ National average=25.1 per 1,000 ◦ NM=1.7 per 1,000 (lower than any reporting state except South Carolina) 4

Likewise, the Legislature has asked for CYFD to focus on prevention and early intervention According to state law, CYFD should: ◦ have a prevention and intervention division (Section 9-2A-4 NMSA 1978); ◦ develop standards of service within the department that focus on prevention, monitoring, and outcomes (Section 9-2A-8(D)); and ◦ implement prevention and early intervention as a departmental focus (Section 9-2A-8(J)); However, CYFD Protective Services resources concentrated on the “back end” of the system. 5

NM CYFD Protective Services 40,606 reports of abuse Prevention <$1 million Early intervention & investigation 22,945 investigations $24.6 million 2,600-in foster care Foster Care and Adoption 311-adoptions $85.8 million 2018 CYFD Protective Services Child 2018 CYFD Protective Services Child Welfare Statistics Welfare Spending 6

Child Maltreatment Prevention/Early Intervention Programs $18.00 What works… $16 $16.00 $14.00 $12.00 $11 Taxpayer Benefit to Cost Ratio $10 $10.00 $9 Non-Taxpayer Benefit To Cost Ratio • Strategic investments, along with ROI $8.00 careful attention to $6.00 $5 implementation and performance monitoring, could $4.00 $3 help the state achieve reductions $2.00 $2 $2 $1 <$1 <$1 in child maltreatment and ($1) $0.00 improve outcomes for New -$2.00 Alternative Response Safecare Nurse Family Partnerships Triple P (All Levels) Parent Child Interaction Therapy Homebuilders Triple P (Level 4) Parents as Teachers Other home visiting programs Healthy Families America Parent Child Home Program Other family preservation Mexico families. • CYFD has a number of options to boost spending to evidence- based prevention programs. Source: LFC Results First 7

Maltreatment Rate Business as usual will not (Business as Usual vs Nurse Family Partnership Intervention) move the needle, but we know what works 40.0% 35.0% MALTREATMENT RATE • Programs proven to work have lasting impacts NFP should decrease occurrence of 30.0% • maltreatment for participants by 26% Without this or other interventions, the state continues on the same path. 25.0% • However, implementation of evidence-based 20.0% programs such as nurse-family partnerships should reduce the maltreatment rate. 15.0% • HSD is piloting Medicaid funded home visiting including NFP which should start in Jan 2019. 10.0% 5.0% 0.0% 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 YEARS FOLLOWING START OF PARTICIPATION Base Rate Treatment Rate 8

NM CYFD Protective Services Engage lower risk child welfare involved families and offer them services ( Alternative Response ) 40,606 reports of abuse Mental Health Prev and Treat ( Triple P Lvl 4 , numerous Medicaid services) 22,945 investigations In-Home Parenting Skills Training ( SafeCare , NFP) 2,600-in foster care 311-adoptions In-Home Parenting Counseling ( Homebuilders ) 2018 CYFD Protective Services Child Welfare Statistics 9

Taxpayer Total What works… Program Description Notes ROI ROI System of responding to referrals to better assess strengths and needs of Piloted by CYFD • Strategic investments, along with Alternative lower risk families and connect them 2005-2007 with careful attention to Response to services good results 4 to 1 16 to 1 implementation and performance monitoring, could help the state achieve reductions Individual-based parenting program in child maltreatment and to help deal with challenging child Discontinued improve outcomes for New Triple P (Level 4) behavior because of cost 2.8 to 1 9 to 1 Mexico families. REC IX reports • CYFD has a number of options to entering into a $1.1 boost spending to evidence- HV program teaching parents skills to million contract for based prevention programs. SafeCare avoid maltreatment SafeCare 3.5 to 1 11 to 1 Discontinued to serve more children Short term, in-home, intensive though non- family-based services targeted at evidence based Homebuilders families facing child removal model 2 to 1 3 to 1 Source: NM LFC 10

Total Hypothetical Projected Program Implementation Strategy Cost Per Unit Total Units Cost Scenario… 14,139 reports • The new CYFD Cabinet Secretary Alternative received in decides to implement the four Response Pilot in Bernalillo County $98 (WSIPP) BernCo $1.4 million programs on the right at different intensities • Alternative response might be Restore previous funding with best piloted in select urban Triple P (Level 4) potential to expand further $1,792 (Casey) 100 families $1.8 million counties then expanded, TBD-CYFD has issued request for whereas Homebuilders could be proposals supporting a targeted implemented system wide home visiting strategy that • The CYFD Cabinet Secretary uses SafeCare includes SafeCare $1,950 (Casey) 100 families $2 million existing resources to measure $7.1 million how programs are being (note CYFD implemented and outcomes (e.g. currently maltreatment, recurrence of spends over maltreatment, foster care entry, $8 million on etc) Implement system-wide non-ev based replacing current in-home in-home Homebuilders services model $3,547 (Casey) 2,000 services) Source: NM LFC 11 Note: Initial costs may be higher than average costs due to additional funds needed for start up

CYFD Short Stayers Short stayers mostly comprise of children in NM percent of children in care custody for less than 48 hours ◦ Initial removal by law enforcement that are short stayers ◦ There is a 2 working court day period used to 48% 50% 45% determine whether to file a custody petition 44% 45% ◦ Short stayers are largely a result of law 40% enforcement removing a child and after further 35% assessment by CYFD, the child is returned home 30% 25% ◦ Most states have moved to allowing child welfare 20% workers to make removal decisions National 15% Average 10% Casey Family Programs and CYFD conducted a 5% study of the issue in 2015 0% ◦ Effect of short stayers include additional costs, and FFY16 FFY17 FFY18 potential for worse outcomes for children Sources: CYFD & Casey Family Programs ◦ The report recommended the Legislature authorize CYFD-PS with removal authority 12

Final Thoughts and Recommendations Families First Act is another pathway to use IV-E dollars for prevention The Legislature has asked CYFD to make prevention a focus The Legislature should consider: ◦ Creating a legislative framework for CYFD to create an alternative response program ◦ Asking the new CYFD secretary to reexamine the need for a prevention/early intervention service area as mandated by law ◦ Note: In 2014 Casey recommended authorizing CYFD Protective Services Workers to have removal authority, if a consideration, the Legislature/CYFD should consider requiring investigators to be licensed social workers CYFD should: ◦ Reexamine the need for a prevention/early intervention service area as established by the Legislature ◦ Reexamine not having licensed social workers acting as investigators ◦ Engage lower risk child welfare involved families, and connect them with needed evidence-based services before the family is in crisis ◦ Move from the current in-home services model to an evidence-based model such as Homebuilders ◦ Use performance management to track implementation and outcomes of programs 13

For More Information Jon Courtney, PhD, Program Evaluation Manager Kelly Klundt, Fiscal Analyst Charles Sallee, Deputy Director 325 Don Gaspar – Suite 101 Santa Fe, NM 87501 505-986-4550 14