Child welfare contractor committed to working through changes

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September 14, 2011 - 7:00pm

Recently, State Auditor Mike Foley reported cost overruns and poor oversight in the Nebraska Department of Health and Human Services' efforts to privatize the child welfare system. In this Signature Story, we get another perspective on that report from Nebraska Families Collaborative, or NFC, one of only two private contractors still participating in the reform.

According to the auditor's report, NFC has a $125 million contract to handle child welfare cases through June 2014 and currently looks after just over one thousand children in the state's Eastern Service Area, which covers Douglas and Sarpy counties. Grant Gerlock of NET News asked Dave Newell, NFC's executive director, if he agrees with the auditor that the transition to a private system has been rocky.

GRANT GERLOCK: Families Matter is the name of the program that HHS is working on. Can you describe the kinds of cases we're talking about in the child welfare system, the kinds of cases that bring a family into the system?

DAVE NEWELL: There's broadly two groups of families that we touch. One would be child welfare families. These are children and families where either a neglect issue has been identified or an abuse issue has been identified where the family needs additional assistance and might require intervention at various levels. So that's one group of families. The other group of families is families who are being touched by the juvenile justice system. It could be a low level issue, for example things like truancy, to criminal behavior for more significant issues. In Nebraska, the system here is connected so we serve both child welfare families and juvenile justice families and those are the kinds of families that would come into the system here.

GERLOCK: All the agencies in NFC (Nebraska Families Collaborative) are involved in this child welfare reform?

NEWELL: Right, so basically what happened is those five agencies (Boys Town, Child Saving Institute, Heartland Family Services, Nebraska Family Support Network, OMNI Behavioral Health) came together and created this new non-profit, which is the NFC. They signed on in addition to all of our other subcontractors. NFC at any given time has approximately 48 providers who are Nebraska companies in our network who help us to serve children and families.

GERLOCK: So how is it that doing things this way makes the system work better for the children and families involved?

NEWELL: Well, the way that this makes it better is our workers, who are called Family Permanency Specialists. They are going in and getting to know the family extremely well and have that relationship with them. One of the other things with the reform that we're really emphasizing is decision-making though what we call "family team meetings." You bring together all the professionals who might be associated with a family, but actually just as importantly all the other people who are potential support for that family. So it might be a grandparent or some other relative. It could be a member of the clergy. It could be a teacher. One of the things we endeavor to do is for every family, identify who are all the people who can support that family. A large part of that focus is, what can we all do working together to support this family so that either their child can reunify with them - which is what happens with most cases, is children reunify - or if that's not possible, what's going to be in the best interest for that child in the long term so they don't grow up in the system.

GERLOCK: In the state auditor's report there were descriptions of overspending and lack of oversight by Health and Human Services. From your perspective as a lead contractor in the program, has this been a rocky transition on your end?

NEWELL: The NFC has been a very stable force in Douglas and Sarpy County. So in looking at the transition over to us, it certainly was not an easy transition, and I'm not going to say that it was. But it was a successful transition. I think we've done extremely well over this last 18 months.

GERLOCK: Well, what's different for NFC? There were the five contractors (Boys and Girls Home, Cedars Youth Services, Visinet Inc., NFC, KVC-Nebraska). Three are gone now. What was so difficult for them that didn't seem to cause as many problems for you?

NEWELL: I can't speak for the other agencies. What I can tell you is why I believe we have been successful. We built on the existing Nebraska network of providers. Child Saving Institute goes back to the 1800s. They're all highly respected Nebraska companies. One of the things that people I think sometimes lose out on is actually Nebraska has always had a public-private partnership. The agencies that we work with in our network of care are agencies that worked with the state prior to this lead-agency model. As an example, the department always contracted with Child Saving Institute. They always contracted with Heartland Family Services. They always contracted with Lutheran Family Services. What changed was rather than the state having to manage all these different subcontracts, now we manage those. But the service delivery remained with those organizations.

GERLOCK: One of the suggestions made by HHS when this reform effort was going underway was that the state could save money by privatizing the program. The auditor's report suggests that instead, costs have risen 27 percent overall, and in the last fiscal year the state spent $6 million more through Nebraska Families Collaborative on the same number of cases that were handled by HHS prior to that. There was a similar increase in cost for KVC, another contractor in southeastern Nebraska. Can you explain what accounts for that increase in cost?

NEWELL: Well here again I can't speak for the auditor. He would have to speak for his own numbers. What I can speak to is when you look at what has happened in other states that have successfully transitioned, one of the things you do see is that it does require greater investment. Our private agencies invested millions of dollars themselves into this effort. The state also invested. And so when you look at Kansas and when you look at Florida, one of the things you will see is that there is a greater investment that becomes necessary. That was reiterated to the legislature in the June 23rd presentation by the National Conference of State Legislators. In that presentation the speaker, (social welfare expert) Jack Tweedy, walked the legislature through the fact that when you do do this, it does require greater investment.

With that being said, there are higher standards associated with what we do. One of the things our contract requires is that we become nationally accredited. For the first time in Nebraska, when we complete that process, the child welfare and juvenile justice system, those services will be accredited.

GERLOCK: After the investment, at what point, I mean would you expect at some point to be doing the same job or a better job for less than the state was doing it, and at what point should that happen?

NEWELL: This process is not a quick one. The fact of the matter is that when this process began Nebraska had ranked near the bottom of the nation for going on 20 years. So it does take time and there are lots of challenges associated with it. As an example, we won't even have the ESA (Eastern Service Area) completely transitioned over until about the end of December. For the first time in my region you have the lead agency very clear in what our functions are. You also have the department very clear in what its oversight functions are. That won't even be complete until around November and December of this year. So we're still very much in the change process. But I think we have made significant progress since we began this process. And I'm really confident of the things that are coming out of LR 37, that we're going to get clarity over time over what are the remaining things that have to change in Nebraska so that we have a system that works for children and families.

GERLOCK: LR 37 is the interim legislative study going on over the summer.

NEWELL: Right.

GERLOCK: There are critics of child welfare reform who say the state should just cut its losses at this point and take back these child welfare cases. What makes you believe that the state is still taking the right approach?

NEWELL: Well, I guess because of what I see happening on the ground with our children and families. We need to be focused on what's working for kids and families. National accreditation is an example, is a standard we need to meet for those kids and families. We have a lower case load than the state used to have. We actually do all the state training of workers, then we do additional training on top of that. That doesn't mean in all those areas that there aren't things we can do to improve. But what you see is if you look over time if you look at a state like Florida or Kansas while there was more investment what was more important was that outcomes started to improve to the point where now Kansas, as an example, is rated as one of the highest in the nation as far as its outcomes for kids and families. So we continue to invest our own private dollars into this initiative because we believe it's what's best for kids and families and we think that we are seeing the right things happen. We think anything else would be a step back for kids and families.

GERLOCK: Dave Newell is executive director of the Nebraska Families Collaborative. Dave, thank you very much.

NEWELL: Thank you.

Discussion

 

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