State plans to privatize all foster care services by summer

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By NANCY HICKS / Lincoln Journal Star

The state plans to privatize all foster care and other services delivered to more than 4,300 children who are wards of the state and not living at home.

State employees would initially assess and monitor children, but private agencies would provide foster homes and group homes and coordinate services, based on a report on the Department of Health and Human Services Web site.

The state expects to contract with a few large agencies or networks for out-of-home care, following the model that HHS began using for in-home care this summer.

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The reform would begin July 1, 2009, the beginning of the next fiscal year. Contractors would be selected by Feb. 1 and contracts signed by March 15, a short period.

Nebraskans interested in child protection and safety programs expressed praise, reservations and questions about the moves that would:

* Privatize all services for children who are wards of the state.

* Turn over the coordination of services done by state employees.

* Contract with just a few large agencies or networks.

“The plan moves the state out of the direct service business and out of making minor decisions. Yet it reserves the state’s authority on major decisions,” said Karen Authier, executive director of the Nebraska Children’s Home Society, an Omaha agency.

Putting all services under a lead agency should be more cost effective and provide for more coordinated services for children, she said.

HHS is currently responsible for more than 6,600 children who are wards of the state, either because of parental abuse or neglect, or because of the child’s misbehavior. About 2,300 of these children still live at home. The rest live in foster homes, group homes, treatment programs, detention center or in  institutions for juvenile offenders. 

 Currently HHS staff find placements for children, make decisions about changes and report to the court. HHS also contracts directly with individual families for many foster homes.

Under the new arrangement, private agency staff would place the children in foster homes or other programs and coordinate the service. HHS also would no longer recruit its own foster families.

The success of privatization will rest on how well HHS staff oversee the work, said Kathy Bigsby-Moore, director of Voices for Children, a statewide advocacy group.

“That hasn’t been their strong suit,” she said, referring to a recent Legislative report on HHS’s poor oversight of contracts for transporting children to appointments and visits with parents.

Success also will depend on whether the state provides enough money for services, she said.

Some lead contract agencies in Florida went belly up trying to make a profit in the first year of that state’s privatization plan and there were complaints that youth had fewer programs while private contractors made money, according to a memo from Carol Stitt, director of the Foster Care Review Board, a state agency that monitors foster care placements.

The reform document says that contractors will be paid a rate per family, with financial incentives and penalties related to meeting specific performance standards.

Health and Human Service Department leaders have held meetings across the state to explain the reform plan to employees and others interested in the plan.

HHS leaders have not provided information on the potential cost of the reform, although the plan document says it “will be accomplished within existing resources.” The document does not indicate whether state case workers would be cut.

The goal is to reduce the number of times children are moved; to eliminate duplication, confusion and inefficiency that occurs when there are multiple agencies providing different services, according to the document.

Reach Nancy Hicks at 473-7250 or nhicks@journalstar.com.