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BILL # SB 1486 |
TITLE: preplacement protocol; out-of-home placement |
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SPONSOR: Farnsworth E |
STATUS: As Introduced |
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PREPARED BY: Patrick Moran |
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The bill would require the Department of Child Safety (DCS) to provide prospective out-of-home placement caregivers with certain information about a child placed in an out-of-home setting. It also requires the provision of additional services to out-of-home caregivers by AHCCCS-registered providers as well other supports to such caregivers for the child, including counseling.
Estimated Impact
We also estimate that the bill will likely increase DCS' out-of-home support services costs by requiring the provision of services, such as counseling, to out-of-home caregivers that are not currently available. There could be similar costs within the AHCCCS budget for services rendered by AHCCCS-registered providers. The dollar level of these impacts will depend on the interpretation of the bill language. The bill does not mandate a particular level of services.
DCS estimates that the bill would generate a total of $27.6 million in state costs annually, including:
· $10.0 million for services to out-of-home care providers seeking services from AHCCCS-registered providers due to emotional, physical, or behavioral damages as a result of a child placed in out-of-home care. AHCCCS indicates, however, that there are too many unknown variables to be able to estimate the impact of this component of the bill.
· $6.2 million for additional services provided by DCS to out-of-home caregivers to assist in the care of the child, mostly for counseling.
· $0.2 million for additional training to DCS employees whose duties involve placement of children in out-of-home care.
As outlined below, DCS' estimated impact is a possible outcome, but their analysis is largely based on their interpretation of the bill rather than specific mandated service levels.
Providing Information to Caregivers
The bill would require the Department of Child Safety (DCS) to provide prospective out-of-home placement caregivers with information about a child's medical and behavioral health, involvement in the juvenile justice system, the reason for the child's temporary custody, the number of the child's siblings, and the number of prior out-of-home placements the
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child has had, including placement disruptions. DCS would need to verify that the information has been provided within 7 days after the child's placement.
Chapter 4, Section 6 of the DCS Policies and Procedures Manual already establishes as department policy that the department shall provide out-of-home caregivers, at the time of placement, a written summary of known information regarding the child, including demographic information, type of custody and previous placement, pertinent family
information, known or available medical history of the child, including behavioral health special education or medical needs and, if applicable, the child's history of adjudication on acts of delinquency. As a result, it appears that the
legislation would largely codify in statute DCS' existing policies and procedures concerning provision of information to prospective out-of-home caregivers.
DCS interprets the bill, however, to require that DCS collect all available information about the child before the child is placed, whereas under its current policy DCS only provides the information the department knows at the time of the placement. As a result, DCS believes that it would need to construct 10 new welcome centers at a cost of $15.2 million, including $4.3 million in rent expenses for 10 new buildings (plus $4.0 million in one-time construction costs) and $6.9 million to hire 117 welcome center staff, to provide temporary beds for children as the department collects all records about the child prior to placement. These assumptions are based on the welcome centers hosting a total of 236 out-of-home children at any given point in time. By comparison, the current out-of-home population is 14,260.
We think DCS' estimate is likely overstated for at least 2 reasons. First, to the extent that DCS is able to obtain all applicable records about the child as outlined in the bill within a week after the placement of the child, the need for welcome centers would be lower than DCS is estimating. Since department policy already requires much of the information in the bill to be provided at the time of placement, the level of new information necessary to satisfy the requirements of the bill is unclear. In addition, Legislative Council believes that the provision in the bill allowing DCS to verify whether the information has been provided 7 days after the placement has been made effectively gives DCS the flexibility to make placements before all records concerning the child are complete.
Secondly, it would depend on whether the Juvenile Court would approve temporary placements in welcome centers. A.R.S. § 8-824 requires that a Preliminary Protective Hearing be held by the Juvenile Court within 5-7 days after a child has been removed from their home, at which time the Court shall enter orders, if necessary, with respect to the placement of
the child until the child's dependency is adjudicated. The Court must give paramount consideration to the health and safety of the child at the hearing. If the court determines that the health and safety of children would be better promoted with a family foster home placement, even if records about the child are incomplete, instead of a placement at a welcome center, the cost of the bill would be lower than DCS' estimate.
Additional Services
The bill would also allow out-of-home placement providers to obtain services from an AHCCCS-registered provider if a foster child inflicts emotional, physical, or behavioral damages on the out-of-home placement provider or an in-home family member. Under A.R.S. § 8-512.01, any such services would be billed to the Regional Behavioral Health Authorities (RBHAs), which are funded through the AHCCCS budget. DCS estimated such services would generate $10.0 million in service costs. AHCCCS concluded, however, that there are too many unknown variables to develop a specific estimate, but believes it would be unlikely that such services would receive federal reimbursement. We concur with AHCCCS' assessment.
The bill also requires DCS to assist the out-of-home placement provider to care for the child, including training to enhance parenting skills, counseling, or other formal or informal supports. DCS states that it does not currently finance support services for out-of-home caregivers. DCS assumes that these services would therefore generate about $6.2 million in additional costs for the agency, most of which ($5.7 million) would be associated with out-of-home caregivers utilizing therapeutic and family group counseling. DCS estimates assume that 25%, or 950 of the 3,800 licensed family foster homes would seek counseling services, and that each request would be associated with 20 hours of counseling. At $300 per hour, these costs would total $5.7 million.
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We concur with DCS that the bill could result in service cost increases, but we think the magnitude is highly uncertain, as we lack information on how frequently out-of-home caregivers may utilize such services.
DCS Employee Training
The bill also requires the department to provide 2 hours of training annually on preplacement protocols, behavioral and medical navigation and timeliness of care to DCS employees involved in the placement of children in out-of-home settings. DCS assumes it would need to hire 2 trainers at a total cost of $156,200 to implement these requirements.
Local Government Impact
None
2/14/20