Maintenance Needs in Performance-Based Contracting Success: The Missouri Project on Privatization of Out-of-Home Care

1. Maintenance Needs in Performance-Based Contracting Success: The Missouri Project on Privatization of Out-of-Home Care for Children Project Director: Rebecca Porter, MSW State of Missouri Children’s Division Lead Evaluator / Co-Evaluator: J. Wilson Watt, MSW, PhD / Lynette Renner, MSW, PhD University of Missouri-Columbia School of Social Work

2. Recent Historical Context 1988 Private/public partnerships established with case management contracts let to private sector agencies 1997 Foster care case management services provided by the private sector with an emphasis on reducing caseloads for state agency staff 1998 Contract for the Interdepartmental Initiative is awarded 2000 Case management contract was re-bid to accommodate growth in the private sector 2004 HB1453 (MO) requires contracts for comprehensive services and evaluation with performance-based criteria 2005 Performance based case management contracts awarded to7 consortia

3. Why Study Missouri • Well-established measurable outcomes for PBC services • PBC contracting incentivized via financial risk/reward tied to permanency • Future contract capacity clearly tied to PBC performance outcomes • PBC rates based on an actuarially sound case rate range

4. Focal Question What is needed in contract monitoring and inter-agency networks to maintain commitment to and successful use of performance-based contracting for out-of-home care for children over time?

6. Dual Data Usage • Quantitative data on five child welfare outcomes • Qualitative data from key informants knowledgeable about child welfare service delivery • Provides both process and outcome products to define PBC best practices

7. Child Welfare Outcomes • Permanency for children in care • Safety for children in care • Stability of placements • Reduction in residential placement • Child and family well-being

8. Key Informant Data on Maintenance Needs • PBC processes that have improved the care of children • PBC processes that have improved interactions of direct and indirect service providers • PBC processes that need adjustment or change at each data point • Barriers to success in continued implementation of PBC processes

9. Children’s Division Internal Data Sources • Internal Quality Assurance processes • Complaint Process for clients of PBC contract agencies • Peer Record Reviews • Quarterly reports • Annual report

10. Agency Consortia Partners • Missouri Alliance for Children and Families (Jefferson City) • Children’s Permanency Partnership (St. Louis) • Catholic Charities Service Agency (St. Louis) • Cornerstones of Care (Kansas City) • Family Advocates (Kansas City) • Boys & Girls Town of Missouri (St. James) • Springfield Partners (Springfield) • Missouri Coalition of Children’s Agencies (Jefferson City)

12. Expected Outcomes • Evidence of the effectiveness of incentivized PBC in the improvement of child welfare outcomes • Additional knowledge about agency and community processes which affect successful implementation and maintenance of PBC as a practice approach • A set of tested “Best Practices” in PBC implementation and maintenance for child welfare practice.