https://abr.ofm.wa.gov/budget/decision-packages/v1?budgetSes... Decision Package Bundle Agency: Dept of Children, Youth, & Families Decision Package Code-Title: HV - Achieving Safe & Stable Placements Budget Session: 2019-21 S1 Budget Level: Policy Level Contact Info: Jennifer Smith (360) 725-4424 jennifer.smith2@dcyf.wa.gov Agency Recommendation Summary Funding requests for getting children and youth into safe and stable placements and decrease or prevent children spending days in the local DCYF offices, nights in hotels, and moving from one foster home to another night to night. Program Recommendation Summary 010 - Children and Families Services Funding requests for getting children and youth into safe and stable placements and decrease or prevent children spending days in the local DCYF offices, nights in hotels, and moving from one foster home to another night to night. Fiscal Summary Dollars in Thousands Operating Expenditures FY 2020 FY 2021 FY 2022 FY 2023 Fund 001 - 1 $0 $4,866 $4,844 $4,844 Fund 001 - 2 $0 $1,875 $1,854 $1,854 $0 $6,741 $6,698 $6,698 Total Expenditures Biennial Totals Object of Expenditure 1 of 5 $6,741 $13,396 FY 2020 FY 2021 FY 2022 FY 2023 Obj. A $0 $482 $482 $482 Obj. B $0 $171 $171 $171 Obj. E $0 $11 $11 $11 1/8/20, 3:36 PM https://abr.ofm.wa.gov/budget/decision-packages/v1?budgetSes... Object of Expenditure FY 2020 FY 2021 FY 2022 FY 2023 Obj. G $0 $14 $14 $14 Obj. J $0 $43 $0 $0 Obj. N $0 $5,832 $5,832 $5,832 Obj. T $0 $188 $188 $188 FY 2020 FY 2021 FY 2022 FY 2023 $0 $1,875 $1,854 $1,854 $0 $1,875 $1,854 $1,854 Revenue 001 - 0393 Total Biennial Totals $1,875 $3,708 Package Description Several years ago, child welfare began seeing a significant placement crisis arise in Washington.  The symptoms of this crisis were: A sudden increase in the number of children and youth who simply lacked any placement and ended up staying overnight with social workers in hotels Increased use of high cost night-to-night foster homes, where the youth is only allowed to stay from 7 p.m. to 7 a.m. Youth with challenging behavioral issues spending their days in the child welfare offices day after day A dramatic increase in the number of youth placed in out of state facilities.  While DCYF has successfully decreased the number of youth placed out of state, we continue to experience too many youths in unstable placements and in offices during the day.  This has led to an increase on assaults on staff, need for de-escalation training for staff in offices, and unsafe situations for youth.  Youth in the offices have damaged property, physically assaulted each other and staff, and clearly suffer from a lack of stability.The level of placement disruption also means that these youths are generally not able to consistently attend school or enjoy the benefits of a therapeutic environment.  Out of control youth are cited again and again by social workers as having a negative impact on job satisfaction, leading to turnover. Many of the youth staying in hotels and offices have already experienced significant trauma in their short lives.  By not creating more stability in their lives, these children simply add to their trauma and their behavior and mental health suffers. DCYF has been tracking individual children experiencing hotel stays and is able to analyze 2 of 5 1/8/20, 3:36 PM https://abr.ofm.wa.gov/budget/decision-packages/v1?budgetSes... this data for trends.  We are in the process of determining how best to track youth experiencing a high degree of placement disruptions more generally. In FY 2018, 271 children experienced 1,269 CA-supervised hotel stays. 190, or 70.1 percent of these children were 9 years of age and older. Thirty percent of the placements prior to a hotel stay were in a foster home and 16.7 percent of the placements were in a Behavior Rehabilitation placement.  The Department of Children, Youth, and Families analyzed the data regarding children who experienced hotel stays between January 1, 2019 and June 30, 2019 and found that: 1. 71 percent of hotel stay events in the state occurred in King County. 2. Males were more likely to have a hotel stay than females; 63 percent compared to 36 percent. 3. Youth 13-17 accounted for the age group with the largest number of hotel stays. Youth 13-17 account for about 40 percent of children with a hotel stay and account for about 42 percent of all hotel stay events (number of nights stayed in a hotel).  4. The youth who experience hotel stays generally and those who stay frequently especially present with a number of challenges including mental or physical health issues, behavior problems, developmental disabilities, and past criminal activity. 5. The number of children/youth with a hotel stay has increased somewhat over the last three years (from 196 in 2016 to 229 in 2018); however, the number of hotel stay events has significantly increased from 818 in CY2016 to 1419 events in CY2018. 6. Black children are more likely to have a hotel stay than other racial/ethnic groups.  However, this finding is confounded by the high rate of hotel stays in King County. This issue is far more complex than just lack of placement resources. DCYF will be conducting a more detailed analysis of the problem, including but not limited to use of placement units, after-hours practices and procedures, child population, and the availability and use of placement resources.   DCYF must take a number of actions to address this complex problem. We are requesting the following resources to alleviate the problem. Additional staff capacity to work with placement staff, caseworkers, regional program staff, foster parents, and contracted providers to identify and help develop appropriate resources for emergent placements and partner to identify practices and processes to minimize the need for emergent placements.  These staff will be able to collaborate with other partners such as the Developmental Disabilities Administration and Department of Behavioral Health to determine if the youth would benefit from other services or placements.  The youth experiencing hotel stays are complex and would benefit from dedicated focus on their placement needs. Increase Emergent Placement Services (EPS) facility based contracted beds by 20 3 of 5 1/8/20, 3:36 PM https://abr.ofm.wa.gov/budget/decision-packages/v1?budgetSes... beds with an increase in beds for 6 to 11-year-olds in region 4.   Increase contracted Child Placement Agency (CPA) receiving care Tier 1 and 2 by 20 beds. This is a contract with CPA who have specially trained foster homes which have beds available for crisis placements.   Increase DCYF receiving care foster home resources by 30 beds statewide, five in each region to start and provide more structure to this placement. Currently this service is used for the emergent night-to-night stays in foster homes.  DCYF would eliminate the ability to use night-to-night stays and replace those with contracted receiving care homes who would provide 24/7 short-term placements.These homes would not be available for long-term or permanent placement.  Develop a contract to support education advocates and coordinators to provide specific interventions for help to get the hard to place, crisis population into school with proper supports needed to maintain attendance.   In addition to these investments in the child welfare system, DCYF recommends creating additional capacity in mental health placements, including at least 10 additional Children’s Long-term Inpatient Program (CLIP) with a potential set-aside or priority for child welfare involved youth.  DCYF also recommends the creation of additional crisis, short-term, and long-term beds for youth in the Developmental Disabilities Administration.  Ten to twenty percent of the foster care population is developmentally disabled, which is much higher than the occurrence of these disabilities in the general population.  Parents of these children can rapidly become burned out and unable to parent children with extreme needs, particularly as they enter puberty.  In addition, these children are more vulnerable and potentially at risk of experiencing abuse and neglect and therefore end up in the child welfare system.  A robust suite of services in DDA including family engagement and support strategies would help divert these youth from entering child welfare. Assumptions and Calculations Expansion or alteration of a current program or service: Not applicable. Detailed assumptions and calculations: 6.0 Social & Health Program Consultant 3: $678,000 to cover salaries and benefits, goods and services, and travel in both years, and an additional $43,000 in FY21 for one-time equipment purchases.    20 Emergent Placement Services (EPS) facility-based contracted beds: $2,208,000 annually. EPS facility beds cost $4,800 fee for service per month per youth plus a base rate of $4,400 per month per bed totaling $9,200 per month per youth.  10 Receiving Care Tier 1 beds: $374,000. Tier 1 beds costs $3,113 per month per youth.  10 Receiving Care Tier 2 beds: $734,000: Tier 2 beds costs $6,113 per month per youth.  30 Receiving care foster homes: $2,160,000. The cost for receiving care foster 4 of 5 1/8/20, 3:36 PM https://abr.ofm.wa.gov/budget/decision-packages/v1?budgetSes... homes is $6,000 per month.  A contract for six education advocates would be $356,000 annually. Workforce Assumptions: 6.0 Social & Health Program Consultant 3: $678,000 to cover salaries and benefits, goods and services, and travel in both years, and an additional $43,000 in FY21 for one-time equipment purchases.   Strategic and Performance Outcomes Strategic framework: This package relates to Results Washington goal efficient, effective & accountable government by ensuring DCYF is funded to adequately support agency specific services. Performance outcomes: Lower hotel, night-to-night and office stays Increase child safety, permanency and wellbeing  Increase educational attainment and attendance  Other Collateral Connections Intergovernmental: OSPI and Treehouse regarding the current contract DBHR about DCYF identified CLIP beds EPS contracted provider and other provide agencies to expand resources  Stakeholder response: Not applicable Legal or administrative mandates: Not applicable Changes from current law: Not applicable State workforce impacts: Not applicable State facilities impacts: Not applicable Puget Sound recovery: Not applicable IT Addendum Does this Decision Package include funding for any IT-related costs, including hardware, software, (including cloud-based services), contracts or IT staff? No 5 of 5 1/8/20, 3:36 PM