House Community Budget Issue Requests - Tracking Id #2087 A Local Plan for Sustainable Funding for Comprehensive, Integrated Community Based Care in Hillsborough County
Requester:	Luanne Panacek		Organization:		Hillsborough County Children's Board
Project Title:	A Local Plan for Sustainable Funding for Comprehensive, Integrated Community Based Care in Hillsborough County		Date Submitted:		01/28/2000 11:54:31 AM
District Member:	Sandra Murman		Service Area:		County
Counties Affected:	Hillsborough
Recipient:	Children's Board of Hillsborough County		Contact:		Luanne Panacek
	1205 E. 8th Ave.		Contact Phone:		(813) 229-2884
	Tampa 33605
Project Description:
This request is being submitted to assist Hillsborough County in the implementation of the first of a three-phase process to establish a comprehensive, integrated system for community-based care in Hillsborough County. This process will assist in development of the necessary infrastructure for the transition to community-based care and will benefit the entire state by establishing a foster care case rate which may be used as a guideline by local public/private partnerships assuming the management of community-based care. In addition, this activity will provide the state with important strategies which can be used during the next three to five years for the identification of potential sustainable sources of revenue to enhance and expand comprehensiveness and further integrate the local system of community-based care. The integration of community-based care means moving increasingly toward a system of services which integrates the child welfare, children?s mental health and substance abuse , juvenile justice and school systems (see attached graphic).Phase I, to begin implementation on July 1, 2000, will serve 300 children within targeted zip code areas in Hillsborough County who are either at risk of or who actually have been adjudicated dependent. All children meeting the Phase I criteria will be served within the specifically defined geographic area (to be determined based on current social indicator data including referrals for abuse/neglect). Phase I is the first phase of Hillsborough County?s privatization of child welfare (also referred to as community-based care) and therefore will be carried out by the lead agency who has been awarded the community-based care contract by the state. It is anticipated that the state will release an Invitation to Negotiate (ITN) for awarding the contract either late in the 2000 legislative session or immediately after the session ends. Those eligible for services during Phase I are children (and their families): (1) determined to be at significant risk of abuse/neglect based on reliable risk assessment data; (2) referred to the abuse registry; (3) adjudicated dependent and in out-of-home care and whose biological family resides within the geographic boundaries; and, (4) reunified with their family or placed in adoptive placements after the onset of the pilot.
Services Provided/Benefit to State:
Services provided within Phase 1 will include: individualized and wraparound services; comprehensive assessment and family support planning; and all services and supports necessary to create a comprehensive, intensive and integrated system of community-based care for children and their families from front-end prevention and early intervention services through post reunification or post-adoptive placement stabilization and follow-up services. Hillsborough County is currently engaged in a number of innovative and related system development projects, which will be either closely coordinated with Phase I activities or will play a direct part in its implementation. These activities include: the establishment of a community-wide Purchasing Alliance to oversee cross-systems, community based care planning and funding; the implementation of a $7 million federal Children?s Mental Health Services grant awarded to the Children?s Board to serve children with severe emotional disturbance; the establishment of Hillsborough Kids Inc., a citizen-driven board to provide leadership in privatization planning; Project Relief, a newly funded respite program; THINKids, a 25 child pilot to serve the most expensive and difficult children in the county who are being served by more than one system; Alternative Strategies for Hard to Place Teens, a project for dealing with difficult to place teens in foster care; Preventing Out of Home Care, a Children?s Board funded activity to develop enhanced family supports; the establishment of a revenue maximization position within the Children?s Board to keep abreast of revenue opportunities at the state and federal level; an 18 month project for family support services to prevent out-of-home care funded by the United Way; national technical assistance on systems planning provided through the National Technical Assistance Center; and Comprehensive Health Planning, including the proposed use of school nurse/case managers at every school site in Hillsborough County to support school-based family support and wraparound teams. (see attached budget allocations for the above activities)
Measurable Outcome Anticipated:
Child/Family Outcomes (sample of outcomes) The number of children coming into foster care will be reduced. The length of stay in foster care will be reduced. The number of placements changes/disruptions for children in out-of-home care will be reduced. Comprehensive assessments will be done on every child and family in need of out-of-home care. Family Support Plans will be developed with the family and implemented within the first 30 days a child is in care. The number of adoptive placement disruptions will be reduced. The number of available foster and adoptive homes will increase. The turnover rate of foster homes will decrease. Community-Based Care Process-Related Outcomes The cost of services and supports for children served by the foster care system will be determined including more accurate information on: The case rate for children served by the dependency system having been served within an efficient, comprehensive, integrated system of community-based care; Board rate based on development age and differential costs ; Allocations needed for improved foster parent recruitment and training; Support services necessary to retain and stabilize out-of-home placements; The cost of enhanced compliance monitoring of out-of-home placements; Allocations needed to embed continuous quality improvement processes in the system to ensure and maintain high quality service delivery and care. Identified mechanisms to maximize funding at the local level. The completion of a comprehensive community-based funding assessment including the identification of the current local, state and federal allocations and funding streams which contribute to each of the components of the integrated system of community-based care. Identification of areas of revenue under-utilization, strategies for use of local dollars for match, and an implementation strategy for recouping federal dollars. Establishment of an integrated system for fiscal accounting and revenue recoupment across child welfare and children?s mental health funding streams (e.g., Title IV-E, TANF, Medicaid, Tobacco Fund). A plan for a sustainable, comprehensive, integrated local system of care for children and families using blended funding techniques which will maximize federal, state and local dollars, including public and private funding. A menu of wraparound services and supports and associated costs by activity needed for quality services throughout the continuum of care (i.e., activity-based cost accounting). A set of shared community outcomes across funders which meet Federal Adoptions and Safe Families Act, a uniform method of collecting, tracking and reporting outcome data, and an annual community ?report card? to communicate progress. A community-wide, integrated, comprehensive management information system. An assessment of existing MIS capacity across funders and providers. The establishment of a relevant data set which can be expanded as the project extends itself county-wide and as the other systems of service are folded in. Identified software which can link with existing local and state management information systems. Established MIS capacity across all involved sites in Phase I including acquisition and installation of software and hardware. A pre-service and on-line training program to ensure the on-going availability of reliable management data. A plan for shifting from contracting for programs of service to a fee for service system in which services are individualized and wrapped around children and their families and therefore dollars follow the children and families being served. A final independent evaluation report of Phase I at the end of 18 months.
Amount requested from the State for this project this year:				$2,150,000
Total cost of the project:		$6,000,000

Request has been made to fund:			Operations
Is there Local Government or Private match for this request?					Yes
	Cash Amount:	$2,275,000
Was this project previously funded by the State?					No
Is future-year funding likely to be requested?					Yes
	Amount:	$1,250,000
	Purpose for future year funding:			Recurring Operations
	Will this be an annual request?				No
Was this project included in an Agency's Budget Request?					No
Was this project included in the Governor's Recommended Budget?					No
Is there a documented need for this project?					Yes
	Documentation:	CWLA Managed Care & Privatization Tracking Project (1998)
Was this project request heard before a publicly noticed meeting of a body of elected officials (municipal, county, or state)?					Yes
	Hearing Body:	Executive Committee, Children?s Board of Hillsborough County
	Meeting Date:	01/27/2000