Report 2015-502 Recommendation 4 Responses

Report 2015-502: Follow-Up—California Department of Social Services: Although Making Progress, It Could Do More to Ensure the Protection and Appropriate Placement of Foster Children (Release Date: July 2015)

Recommendation #4 To: Social Services, Department of

To ensure that counties' use of foster family agency placements is justified, Social Services should take action to implement the recommendation we previously made in our 2011 audit. Specifically, Social Services should require counties to give licensed foster homes a higher priority than foster family agencies for children that do not have identified treatment needs.

Annual Follow-Up Agency Response From November 2020

Will not implement, and recommend closure of the issue for the reasons provided in the subsequent response.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

We are disappointed that Social Services continues to not take steps to address this recommendation to ensure that counties' use of foster family placements is justified.

Annual Follow-Up Agency Response From November 2019

By law, counties are legally responsible for placement decisions as well as case planning and management for the child or youth. The counties must determine the appropriate placement after making a comprehensive assessment of the needs and best interests of the child or youth, including determining who will provide the services. As stated in our previous response, all resource parents are now held to the same standards and are paid the same basic rate even for the FFA resource home. However, the FFA administrative portion of the FFA rate continues to support the ability of the FFA to provide an array of services and supports and to recruit, retain, and train resource parents. FFAs must ensure that trauma-informed core services are made available to youth in FFA placements. The FFA expectations are outlined in the FFA placement agreement. FFAs can provide additional services that may include, but are not limited to, conducting resource family approvals for county homes, training of county resource parents, providing extra transportation, providing access to community resources or materials, and providing specialized permanency or intensive services. The use of FFAs continues to vary by county. CDSS supports the partnership with the FFAs that provide a viable placement option and an array of services, supports and other resources for children and youth as part of the continuum of care.

California State Auditor's Assessment of Annual Follow-Up Status: Will Not Implement

We are disappointed that Social Services continues to not take steps to address this recommendation to ensure that counties' use of foster family placements is justified.

Annual Follow-Up Agency Response From November 2018

Estimated date of completion is pending the finalization and full implementation of the Level of Care Protocol (LOC).

The first phase of implementation of the new LOC began March 1, 2018 with FFAs. Full application of the tool to other home-based family settings has been delayed pending the release of an updated/modified tool from CDSS. It should be noted that the distinction between FFA families and foster family homes is no longer applicable. All families that care for foster children are now approved by the same standards known as the Resource Family Approval.

Treatment needs and services are not based on where a child is placed. Services are intended to be brought to the home, and when possible, moving a child to another placement is avoided. In addition, CDSS has selected the Child and Adolescent Needs and Strengths Tool to inform the care planning and level of care decision-making based on a child/youth's strengths and needs, and for monitoring the outcomes of services provided to the child/youth.

California State Auditor's Assessment of Annual Follow-Up Status: Pending

This recommendation has been outstanding since the release of the original audit in October 2011. We are hopeful that Social Services is serious in its stated intent to address this recommendation by February 2019.

Annual Follow-Up Agency Response From December 2017

The actions taken by the Department in January, 2017 address the concerns articulated in the 2011 Auditor's assessment. The Level of Care Protocol is a new rate determination process that will be used to support all children and youth living in a home-based family setting. Although the implementation of the Rate Protocol is delayed until February 1, 2018, the Resource Family Approval (RFA) process is currently operational. Since January 1, 2017, all families are approved by the same standard. There no longer is a distinction between treatment and non-treatment licensed foster family homes for foster family agencies (FFAs) or county licensed foster family homes, nor is there a need to determine a priority of usage between an FFA or county licensed family home. The old criteria for placement into an FFA required children to have higher treatment and service needs. The new standard for placement is based on a level of care protocol for which applies to all children without regard to the placement type.

California State Auditor's Assessment of Annual Follow-Up Status: Partially Implemented

Annual Follow-Up Agency Response From November 2016

Effective January 2017, all foster and certified homes, and relatives instead will be licensed as a Resource Family (RF). All County Letter (ACL) 16-58 (see link below) outlines these standards. The need for preference to place in a foster family home as a priority will no longer be applicable given how foster homes, certified homes and relatives will be approved. Children will be placed based upon assessed needs, rather than the old treatment standards.

http://www.dss.cahwnet.gov/lettersnotices/EntRes/getinfo/acl/2016/16-58.pdf

California State Auditor's Assessment of Annual Follow-Up Status: Not Fully Implemented

1-Year Agency Response

Assembly Bill (AB) 403 requires Foster Family agencies (FFAs) to meet new program standards which include providing services to relative caregivers and county licensed homes, upon request by the county, and making available core services to children/youth. FFAs will also be required to become accredited by a nationally recognized accreditation agency. Since the authorization of AB 403, CDSS has released a revised rates structure with the May Revision budget on May 13, 2016 (Attachment 3). The revised rate structure creates a new basic rate which is applicable to all foster families including county licensed foster homes and relatives. Rates will be paid based on an assessment of the level of need. The rates structure was developed in accordance with the following framework:

- Rates will be a prospective pre-determined amount.

- Reasonable methods will be used for quantifying the costs of changes to the system.

- The rate structure is based on the needs of the youth and level of care.

- CDSS is committed to collecting cost data to quantify anticipated costs of the program changes, but budget realities may also impact the final rate setting revisions.

There are a considerable number of pre-implementation activities yet to be completed between now and January 1, 2017. CDSS will be issuing guidance to the providers and counties by July 2016, announcing the rates structure and rate amounts, revising costs reports in order to capture costs and revenue at a more detailed level and providing technical assistance to assist agencies with the transition. CDSS will continue to work with providers, stakeholders and counties.

California State Auditor's Assessment of 1-Year Status: No Action Taken

We believe Social Services should take action and require counties to give licensed foster homes a higher priority than foster family agencies for children that do not have identified treatment needs. By not making our recommended regulatory changes, Social Services has allowed counties to continue placing children in the more costly foster family agency placements when lower-cost placements with licensed foster homes may be more appropriate.

6-Month Agency Response

Assembly Bill (AB) 403 was passed in October 2015 and modifies the program expectations of foster family agencies as part of the continuum of home-based family settings. The revised rate system for Foster Family Agencies (FFAs) is being structured to support the new program changes outlined in AB 403. Pursuant to AB 403, a core set of services will be made available to all children placed in home-based family settings, without regard to the placement type (i.e. FFAs certified homes, county licensed homes and relatives). Placement decisions and services will be based on the needs of a child or youth and not prioritized by placement type. CDSS held six FFA/Continuum of Care Reform rates workgroup meetings from April 2015 through August 2015. The input obtained from these meetings provided valuable information for CDSS's consideration in developing the rate methodology, and offered suggested methods for reasonable documentation to justify the various components of the FFA rate, such as making revisions to the cost reports, exploring the value of provider time studies, and making modifications to FFAs program statements. CDSS will continue to work with stakeholders, counties, and foster care providers to implement a relevant and comprehensive rate system that meets the intent of the Continuum of Care/AB 403 and addresses the concerns identified in the 2011 audit.

California State Auditor's Assessment of 6-Month Status: No Action Taken

We believe Social Services should take action and require counties to give licensed foster homes a higher priority than foster family agencies for children that do not have identified treatment needs. By not making our recommended regulatory changes, Social Services has allowed counties to continue placing children in the more costly foster family agency placements when lower-cost placements with licensed foster homes may be more appropriate.

60-Day Agency Response

See response to Recommendation 3.

California State Auditor's Assessment of 60-Day Status: No Action Taken

We believe Social Service should take action and require counties to give licensed foster homes a higher priority than foster family agencies for children that do not have identified treatment needs. As we mention in our report, if Assembly Bill 403 is enacted, the earliest date Social Services could issue regulations or instructions through an all-county letter would be January 2016. This will be more than four years since we made our original recommendation. By not making our recommended regulatory changes, Social Services has allowed counties to continue placing children in the more costly foster family agency placements when lower-cost placements with licensed foster homes may be more appropriate.

All Recommendations in 2015-502

Agency responses received are posted verbatim.