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Quality Improvement Center on the Privatization of Child Welfare Services

Quality Improvement Center on the Privatization of Child Welfare Services. Illinois Department of Children & Family Services. Striving for Excellence: Extending Performance-Based Contracting for Residential Care & Independent Living Programs. Goals of Striving for Excellence.

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Quality Improvement Center on the Privatization of Child Welfare Services

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  1. Quality Improvement Center on the Privatization of Child Welfare Services Illinois Department of Children & Family Services Striving for Excellence: Extending Performance-Based Contracting for Residential Care & Independent Living Programs

  2. Goals of Striving for Excellence • Build on success in foster care and kinship case management • Expand public-private partnership • Improve outcomes for children and youth • Address CFSR deficiencies in Permanency and Well Being • Inform the field through rigorous evaluation of the process

  3. Joint Public Private - Partnership • Illinois Department of Children and Family Services • Child Care Association of Illinois • Child Welfare Institute

  4. PBC in Illinois – the Foster and Kinship Care Experience • Implemented in 1997 • Full casework assignment to private agencies • Rewarded good performance & penalized poor performance • Reduced utilization from 46,500 in 1997 to 15,100 in 2006 • Improved Permanency • Continued realignment of performance measures to enhance client well being

  5. Current Status of Residential Treatment in Illinois • Provided solely by private agencies • Utilization reduced to 1,300 from 4,200 in FY 95 • Changing expectations and evolution of treatment services • Impact of serving youth with severe behavioral health challenges

  6. Current Status of Residential Treatment in Illinois • Individualized cost based rate methodology • Rigorous monitoring by specialized DCFS staff • Capacity challenges – assuring availability of appropriate level of treatment based upon client needs • Must address poor stability and well being performance as noted in CFSR findings

  7. Residential Care Utilization

  8. Identified Independent (ILO) and Transitional Living Programs (TLP)Program Deficiencies • Confused program model • ILO • TLP • No admission guidelines • Inconsistent casework model • Inadequate monitoring

  9. ILO – TLP Reforms • Redesigned to be consistent with the needs of youth who are in care • Clarify and standardize expectations of service providers and the youth who utilize the program • Assign level of care based on youth’s education level and needs • Privatization of casework responsibility

  10. ILO - TLP Care Utilization

  11. January 2007 March 2007 March-May 2007 Formation of Public/Private Steering Committee Data Summit Held with University Partners Measures Developed through Committee Process Key Project Implementation Dates

  12. May 2007 May-July 2007 July-Sep 2007 October 2007 Convene Statewide Provider Forum Finalize Measures and Model Contract Contract Negotiations Held with Providers Demonstration Contract Begins with “Hold Harmless” Provision Key Project Implementation Dates

  13. April 2008 May 2008 June 2008 July 2008 Second Statewide Provider Forum Consider Provider Feedback and Finalize PBC Plans Negotiate individual contracts with service providers Full implementation of PBC Key Project Implementation Dates

  14. Program Design • Statewide Provider Forums held on an annual basis to gather and disseminate information and share best practices • Use of the existing Child Welfare Advisory Committee (CWAC) process to develop, refine and implement PBC • CWI to provide constant feedback to all stakeholders of their evaluation

  15. Potential Measures Under Discussion • Process Measures • School performance • Inappropriate behaviors • Placement stability • Outcome Measures • Changes in client functioning • Post discharge disposition

  16. Evaluation Design • Contingent upon cross-site evaluation needs of the QIC • To be determined after Data Summit is held with university partners • Initial plans include surveying providers and state staff immediately to determine preconceived perceptions of the process and potential barriers to implementation

  17. Project Challenges • Establishing baseline data – the “control group” dilemma • Achieving Public – Private agreement on scope of problem to be solved • Reliability of measures • Fidelity of reporting • Capacity/supply limitations for some types of care • Variable reimbursement rates • Recent reforms in ILO/TLP

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