Monitoring Child Welfare System Performance and Cultivating Improvement in a Families First Prevention Services Act Environment

The 2018 Families First Prevention Services Act (FFPSA) and similar legislation in California (Continuum of Care Reform, or CCR) promotes three major tenants in child welfare systems: 1) minimize the time children spend in congregate care in favor of family-based homes, 2) select services based on evidence of their effectiveness, and 3) place a greater emphasis on prevention. Earlier federal policies exerted pressure on child welfare systems to reduce reliance on out-of-home-care, but FFPSA and CCR press harder, particularly on reducing the use of group care. Doing so requires more precise performance measurement and monitoring across the spectrum of care providers that have to absorb the desired reduction in group care use.

Members of this roundtable will discuss state, county, and provider perspectives on the tenants underpinning these new policies. San Francisco panelists from the County and a congregate care provider agency will describe how better performance monitoring among out-of-home care providers is cultivating outcomes improvement for children. The present fee-for-service reimbursement system under Title IV-E has adverse fiscal consequences for child welfare agencies and their providers that successfully reduce the use of out-of-home care. Performance Based Contracting (PBC) represents a way to minimize those fiscal consequences while promoting evidence-driven improvement.

The panelist from the State of California, a state-supervised, county administered child welfare system, will react to the PBC model and the criticisms of quantifying performance in child welfare systems. The panelist will also discuss how other approaches to monitoring system performance are being developed under CCR.

Panelists will also discuss policy conundrums that arise under the new legislation. For example, how will FFPSA's emphasis on prevention impact substitute car provider agencies, whose business model depends upon the volume and duration of children using out-of-home care? Furthermore, only services that are backed by increasingly strong evidence will be reimbursable under Title IV-E. Absent IV-E waivers, how will jurisdictions finance testing and building on strategies that are not yet recognized as evidence-based? How will researchers continue to field test new and developing interventions?