Projection the Cost of Extending Foster Care to 21

1. 1 Projection the Cost of Extending Foster Care to 21

2. 2 Welcome Second in a series of webinars to support implementation of the older youth provisions of Fostering Connections Partnership between Fostering Connections Resource Center, Jim Casey Youth Opportunities Initiative, the National Foster Care Coalition, and The Finance Project

3. 3 Today�s Webinar Presents considerations in developing fiscal analyses of extending IV-E eligibility to 21 Highlight experiences of two states who have completed costs projections Include opportunities for questions Today presenters: Barbara Langford, The Finance Project Carol Behrer, Youth Policy Institute of Iowa Debbie Miller, Vanderbilt Child and Family Policy Center Lane Simpson, Tennessee Department of Children�s Services

4. 4 Webinar logistics and Q&A Control Panel features �Grab tab�: click on the arrows to open/close control panel throughout the presentation. Questions pane How to ask a question Type a question for presenters into the text box at the bottom of the question pane and hit �SEND�

5. 5 About the Fostering Connections Resource Center Mission: The Fostering Connections Resource Center is dedicated to providing timely and reliable tools and information on all aspects of the Fostering Connections Act to ensure that state, tribal and local decision makers are well-informed about the new law and that they receive maximum support as they plan for and carry out its implementation. Supported through generous contributions of: The Annie E Casey Foundation Casey Family Programs Dave Thomas Foundation for Adoption Duke Endowment Eckerd Family Foundation Jim Casey Youth Opportunities Initiative Sierra Health Foundation Stuart Foundation Walter S. Johnson Foundation

6. 6 What does the Resource Center provide? Nonpartisan data and resources on each section of the bill A user-friendly website at www.fosteringconnections.org serves as a central clearinghouse of customized tools and information Technical assistance� The Resource Center responds directly to questions from state and tribal leaders and can connect decision makers with other experts and TA providers � Monitoring of implementation activity Visitors can stay up-to-date on federal regulatory activity on implementation, events in the field, congressional oversight hearings and learn about best practices and state and tribal approaches to implementation Opportunities to communicate with experts and peers� Subscribe to mailing lists, join webinars and online discussion forums; and stay informed about major events and conferences hosted by the Resource Center and its many collaborating organizations.

7. 7 Resource Center Networks & Collaborating Partners Networks are managed by issue experts at the Resource Center who work with a leading partner organization: Kinship/Guardianship Jennifer Miller/Children�s Defense Fund Education Madelyn Freundlich/ABA Legal Center for Foster Care and Education Adoption Kerry DeVooght/North American Council on Adoptable Children Health Marci McCoy-Roth/National Academy for State Health Policy Older Youth Barbara Langford/National Foster Care Coalition Tribal Madelyn Freundlich/National Indian Child Welfare Association More than 25 national organizations serving as collaborating partners We welcome the opportunity to feature resources by and contact information for state & tribal organizations. Contact us at info@fosteringconnections.org

8. 8 Calculating the Net Fiscal Impact of Extending IV-E Eligibility Determine key design elements of extending care Determine potential sources of revenue to offset costs from existing state and Chafee funding Develop cost estimates based on design decisions Analyze net fiscal impact of extending IV-E eligibility

9. 9 1. Key Design Considerations Scope: Extending eligibility for foster care maintenance, guardianship and/or adoption assistance Programmatic Considerations Eligibility Case Management Placement Options Judicial Considerations Judicial Oversight Legal Representation Right of Return

10. 10 2. Determine Sources of Revenue (Potential State Savings) Identify funding sources that currently support 18 to 21 year olds Case management Housing and/or placement costs Typically state-funded transitional or independent living programs Also might include Chafee funds

11. 11 2. Calculating Potential Cost Savings: Considerations What supports will remain in place if IV-E eligibility is extended? (Of current state spending, what portion can be considered �saved�?) As companion programs to foster care If extending eligibility incrementally (e.g. to 19) for young people not covered

12. 12 3. Develop Cost and Revenue Estimates De-linking IV-E eligibility for adoption subsidy from AFDC Extending adoption assistance Implementing and/or extending guardianship assistance Extending foster care maintenance Other costs

13. 13 De-linking Adoption Assistance from AFDC Phased-in elimination of IV-E Adoption Assistance income test beginning with youth 16+ in 2010; elimination for any child in care 5 years or longer Data/estimates required: Estimated number of children and youth eligible for adoption assistance as a results of changed income requirements % of adoption subsidies paid with state-only funds Average adoption subsidy costs

14. 14 De-linking Adoption Assistance from AFDC: Considerations Each state will receive new revenue that is required to be reinvested in the child welfare system Amount depends on success in achieving adoption, in early years � particularly for success in moving older youth to adoption; FMAP States with larger investments of state funds see more savings Revenues increase over time as the de-link phases in Child welfare agencies have discretion over these dollars � may or may not be able to be used to offset costs of extending IV-E eligibility broadly. Typically able to offset costs of extending adoption assistance to 21.

15. 15 Extending Adoption Assistance Data/Estimates Required: Estimated number of youth adopted at age 16 or older; % who meet FC requirements Average adoption subsidy for 16 + IV-E adoption penetration rate State FMAP rate Also factor in costs for non-recurring expenses and extended post-permanency supports Typically a modest investment for most states

16. 16 Extending Guardianship Assistance To extend guardianship subsidies to 21, states must first create a GAP program for 0 to 18. Fiscal analysis can include GAP for 0 to 18 as well as 18 to 21 under the theory that cost savings of the GAP could be used to offset increased costs of extending foster care maintenance. Can also include projected savings from potential shifts from foster care to guardianship placements.

17. 17 Extending Guardianship Assistance Data/estimates required: Estimated number of children and/or youth eligible to receive guardianship subsidy Estimated number of 18 to 21 year olds who were placed in guardianship placement at age 16 +; % meeting FC requirements Monthly subsidy cost IV-penetration rate State FMAP Also factor in non-recurring expenses and post-permanency supports

18. 18 Extending Foster Care Maintenance Most complicated calculation Costs can vary significantly based on assumptions used Clear, transparent, and shared assumptions are critical to success

19. 19 Extending Foster Care Maintenance: Data Required Placement costs for various placement types Staffing costs: caseworker, support staff, supervisors and/or private contracts for case management Indirect/administrative costs IV-E foster care penetration rate IV-E administrative reimbursement rate State FMAP

20. 20 Extending Foster Care Maintenance: Estimates Required Uptake rate: estimated number of youth who will remain in care; % who will meet FC requirements; length of stay; re-entry Placement settings: distribution of young people across placement settings Case management: % of cases contracted vs. agency-delivered case management

21. 21 Other Costs to Consider Additional supportive services Judicial costs Data and MIS system improvement Additional IV-E eligibility staff

22. 22 4. Determining the Net Fiscal Impact Consider potential savings identified in step 2 and projected IV-E revenue, combine with cost projections to determine net fiscal impact of extending care across IV-E program areas.

23. 23 Iowa: Impetus and Structure Children�s Justice State Council (chaired by the Chief Justice of the State Supreme Court) developed a taskforce to consider costs of extending care to 21 Support from TFP around design and fiscal questions Fiscal analysis began in June 2009; concluded in early 2010 Included a kick-off meeting, 2 design subcommittee meetings, and meeting to present findings; additional conference calls

24. 24 Iowa: Current Programs Supervised Apartment Living (state funded) for young people through age 19 voluntarily in care while finishing high school Aftercare services for 18 to 21 year olds who have aged out (Chafee) PAL program -- financial support for 18 to 21 year olds who have aged out (state funded) Education assistance � ETV and state-funded scholarship programs Currently, over $5 million in state and federal funds being invested in 18-21 year olds in IA

25. 25 Iowa�s Key Design Assumptions Eligibility Continued custody to 21; consistent case management and transition planning services Voluntary Allow re-entry

26. 26 Iowa�s Key Design and Cost Assumptions Case management Privatize through contracted provider network Current caseload standard used in after-care services Placement settings Maintain family foster homes Develop network of transitional placements Develop network of independent living placements Continue basic after-care services

27. 27 Iowa�s Key Design and Cost Assumptions Judicial Oversight Minimum of court review every 6 months; hearing as informal as possible Maintain legal representation Supportive Services Built into transitional placement setting Leadership and self-advocacy skills Educational/Vocational Specialists Jim Casey Youth Opportunities Initiative Opportunity PassportTM model

28. 28 Scope of Fiscal Analysis Extending Adoption Subsidies Extending Foster Care to 21 Supportive Services Judicial Costs Marginal costs of incremental implementation: to 19, to 20, and to 21 Analysis of Guardianship Assistance Program conducted separately by the Department Adoption Assistance de-link revenue was not included as the Department is dedicating those funds to support increased state costs for the program.

29. 29 Extending Adoption Subsidy to 21: Assumptions 5 youth ages 16 and 17 will exit care to adoption each year. 5 youth ages 18-20 are projected to achieve adoption annually.� The average monthly adoption subsidy rate is estimated at $704 per month. Assumes $700 in non-recurring expenses per youth $50,000 in one-time costs related to SACWIS changes.� The IV-E penetration rate for adoption subsidies for older youth estimated at 76%.�

30. 30 Net Costs of Extending Adoption Subsidy to 21 2011: $17,167 2012: $48,925 2013: $49,869 2014: $50,831 2015: $51,812

31. 31 Extending Foster Care to 21 Cost Assumptions: Uptake Rates 53% of 18 year olds will remain in care for 12 months. 35% of 19 year olds who stayed in care through age 18 will remain in foster care 25% of 19 year olds that aged out of foster care will re-enter; average length of stay for 19 year olds is projected to be 6 months 32% of 20 year olds who stayed in care through age 19 will remain in foster care. 12% of 20 year olds that aged out of foster care will re-enter; average length of stay for 20 year olds is projected to be 6 months

32. 32 Extending Care to 21 Cost Assumptions: Placement Settings Family-Based Foster Care 20% of 18 year olds 5% of 19 year olds 5% of 20 year olds $574 per young person per month paid to the provider Transitional Placement 35% of 18 year olds 20% of 19 year olds 10% of 20 year olds $1117 per young person per month paid to the provider $329 per young person per month in service costs Independent Living (PAL) 45% of 18 year olds 75% of 19 year olds 85% of 20 year olds $700 maximum payment and $595 average payment per young person per month paid directly to the young person

33. 33 Extending Care to 21 Cost Assumptions: Case Management Fully privatized Maximum case management reimbursement is $375 per month including court responsibilities. Contract oversight � Contract for caseworker training, network coordination, evaluation increases proportionate to case load

34. 34 Extending Care to 21 Cost Assumptions: Judicial Oversight No additional costs will be incurred for court personnel. The cost of representing a young person will be calculated at $363 per review period per young person. No additional costs will be incurred for county attorneys.

35. 35 Extending Care to 21 Cost Assumptions: Additional Supports Educational and Vocational Supports: Two FTE�s dedicated to educational planning. Financial Literacy: Expands the Jim Casey Youth Opportunities Initiative Opportunity PassportTM model to 100 additional young people per year. Specialized Services for Youth with Mental Health Issues: Private provider agency will coordinate closely with the adult mental health system. No additional costs. Leadership and Self-Advocacy: Phased in expansion of Elevate model statewide over a 5-year period.

36. 36 Extending Care to 21 Revenues State Revenue Already Allocated Current PAL funding SAL maintenance payments for young people 18+ SAL service costs for young people 18+ State Title IV-E maintenance and administrative match funds for young people 18+ State MIYA funds (Medicaid) Federal Revenue IV-E maintenance and administrative match funds Chafee Medicaid Funds Aftercare budget (Chafee) will remain intact to serve young people who opt-out of continued foster care

37. 37 Net Costs of Extending Foster Care Maintenance to 21 To Age 19: Total cost ranges from $425,000 in FY11 to $1,000,000 in FY15 Includes $275,000 in supportive services in FY11; $275,000 in Medicaid costs (increased utilization) To Age 21: Total ranges from $1.1 million in FY11 to $2.4 million in FY15 50% of the increase is in Medicaid costs (represents less than one-half of one percent of the state�s Medicaid budget)

38. 38 IA: Key Lessons Learned Multiple design decisions are necessary to inform cost analysis Critical to know how much and where current resources are being used Requires data from several sources Important to develop projections that allow for segmenting costs Process can provide opportunities to consider supports beyond case management and placement Be clear and transparent about assumptions and how projected costs are calculated

39. 39 TN: Impetus and Structure Participation in Jim Casey Youth Opportunities Initiative (JCYOI) since 2003 Legislation created Independent Living Oversight Committee (ILOC) in 2009 DCS, ILOC, and leaders of JCYOI convened a working group Summer 2009 Support from TFP around design and fiscal questions Work began in August 2009; concluding in early 2010 Legislation proposed in 2010

40. 40 Current Programs in TN Transitional Living � Youth Villages Post-custody Services - DCS Opportunity Passport � Monroe Harding Transition into Adult-based Services

41. 41 TN�s Key Design Recommendations Eligibility Any young person in care on the last day of the 17th birthday, including those in the juvenile justice system Allow re-entry through a trial discharge process Young people ages 21 � 24 would continue to have access to voluntary post-custody services Case management Permanency will continue to be a focus of case management Caseload size will be 1:25

42. 42 TN�s Key Design Recommendations Placement settings Placement decisions will be made in partnership with the young person and will represent the least restrictive option based on the level of maturity and functioning of the young person Placement settings will include Traditional and therapeutic foster care Group care Child care institutions Supervised independent living settings When appropriate, young people have the option to pursue reunification with their family. �Trial home visits� will remain open to young people 18 to 21

43. 43 TN�s Key Design Recommendations Judicial Oversight Foster Care Review Boards (FCRB) implemented statewide and will review cases every 6 months Annual permanency hearings will focus on reviewing and certifying recommendations of FCRBs

44. 44 Scope of Fiscal Analysis De-linking Eligibility for Title IV-E from AFDC for Adoption Subsidy Extending Adoption Subsidies Extending Guardianship Subsidies TN already had a IV-E Waiver for its GAP (0 to 18) Extending Foster Care Maintenance

45. 45 Extending Care to 21 Revenues State Revenue Already Allocated Voluntary Post-Custody Services State Title IV-E maintenance and administrative match funds for young people 18+ Federal Revenue IV-E maintenance and administrative match funds Chafee Adoption de-link revenue Total: $3.5 million annually Transitional Living Services budget remained intact to serve young people who opt-out of continued foster care

46. 46 Estimated Revenue from Adoption De-link 2010: $157,834 2011: $437,124 2012: $688,091 2013: $1,090,820 2014: $1,566,518 2015: $1,971,433 Assumed new revenue could be used to off-set additional costs

47. 47 Extending Adoption Subsidy to 21: Assumptions 90 youth ages 16 and 17 will exit care to adoption each year 7% of youth ages 18-20 are projected to achieve adoption annually The average monthly adoption subsidy rate is $715 per youth. $1500 in non-recurring expenses for every youth that exits to adoption.

48. 48 Net Costs of Extending Adoption Subsidy to 21 2011: $242,882 2012: $662,683 2013: $1,120,165 2014: $1,318,444 2015: $1,380,109

49. 49 Extending Guardianship Subsidy to 21: Assumptions Approximately 35 youth ages 16 and 17 will exit care to guardianship each year. 15 youth ages 18-20 are projected to exit care to guardianship annually. The average monthly guardianship subsidy rate is $715 per youth. $1500 in non-recurring expenses for every youth that exits to guardianship.

50. 50 Net Costs of Extending Guardianship Subsidy to 21 2011: $280,603 2012: $529,784 2013: $550,525 2014: $572,096 2015: $594,530

51. 51 Extending Care to 21 Cost Assumptions: Placement Settings Family-Based Foster Care $1455 per young person per month, 100% private provider rate 4% increase annually Additional DCS case management costs Group Care $3703 per young person per month 3% increase annually Supervised Independent Living $1200 per young person per month Number of placement slots created annually 3% increase annually

52. 52 Extending Care to 21 Cost Assumptions: Case Management DCS-provided Caseload ratio 1:25 Salary of caseworker, supervisor and team coordinator Overhead of $15,000 per staff member Administrative rate of $11,471 per staff member

53. 53 Net Costs of Extending Foster Care Maintenance to 21 Uptake rate of 70% among 18-year olds, expanded use of Supervised Independent Living placements 2011: $2,912,825 2015: $5,358,557 Uptake rate of 50% among 18-year olds, expanded use of Supervised Independent Living placements 2011: $1,002,897 2015: $3,712,322

54. 54 TN: Key Lessons Learned Youth voice is essential Legislative champions Good data � locally and from other states Build on existing programs and partnerships Involve Private Providers early DCS can�t do it alone

55. 55 For More Information Fostering Connections Resource Center www.fosteringconnections.org Copies of this presentation, as well as an audio recording, will be available the Older Youth page NACAC�s tool for calculating revenue from Adoption Assistance De-Link and webinar discussion posted on the Adoption page Check out the Kinship/Guardianship page for additional resources The Finance Project Barbara Langford: blangford@financeproject.org National Foster Care Coalition Kathi Crowe: kcrowe@nationalfostercare.org

56. 56 Stay Tuned! Sign up for the e-update from the Fostering Connections Resource Center Spring Newsletter on Older Youth Issue Briefs and Tools Designing Foster Care to 21: A Discussion Guide for State Leaders (Spring 2010) Upcoming webinars: Strategies for making the case for investments in older youth

57. 57 We invite your questions The Resource Center is pleased to answer questions about any topic related to implementation. Please email questions to info@fosteringconnections.org The Resource Center can also broker or offer limited technical assistance to agencies. Again, please send inquiries to info@fosteringconnections.org.