Child and Family Services Agency

Fiscal Year 2010 Performance Oversight Questions (Round 2)

(Please answer all questions for FY 2009 and FY 2010 to date)

1. Please provide a full status report on the agency’s progress towards complying with the
following FY 2010 Budget directives and recommendations:
• The Committee directs the Agency to eliminate all contracts for paid mentoring
after they expire on January 30, 2010. For FY 2010 the mentoring contracts total
approximately $2.5 million. Of the amount unexpended following the expiration
of these contracts in January 2010, the Committee directs $1,190,000 to be
allocated for the re-establishment of the Rapid Housing Program. At this
funding level the program will be able to support 150 families and 110
emancipating youth in FY 2010. The Committee directs the Agency to use the
remaining funds to support a transition to volunteer mentoring services. An
action plan outlining how the Agency will move forward in building volunteer
mentoring capacity.

• The Committee recommends that CFSA in coordination with the Court Monitor
and Plaintiffs in the LaShawn case evaluate whether contracting and procurement
authority should be transferred back to the Office of Contracts and
Procurement, and make a joint recommendation to the Committee.

• The Committee directs the Agency to submit plans for a differential response
system that will be reflected in the Agency’s FY 2011 budget request. The plan
should reflect the Agency’s collaboration with community based organizations.
CFSA shall adopt policies and procedures for the implementation of the
differential response system that furthers the Agency’s mission and uses
evidence-based features of differential response from other state systems. CFSA
shall ensure that all workers are aware of and receive the appropriate training on
the policies and procedures guiding the implementation of the differential
response system.

• The Committee directs the Agency to gather data and provide analysis of
outcomes for children youth and families as a result of co-location of CFSA in-
home social workers and aides to the Healthy Families Thriving Communities
Collaboratives, specifically reporting on the increase or decrease of substantiated
abuse and neglect complaints regarding residents of each collaborative area, the
increase or decrease in number of social worker visits to families, and the
increase or decrease of family team meetings conducted prior to out of home
placement.

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

• The Committee directs the Agency to gather data and provide analysis of
outcomes for low or moderate risk families that have been referred to the
Healthy Families/Thriving Communities Collaboratives to be submitted to the
Committee on a quarterly basis beginning January 1, 2010. The analysis should
identify the category of the initiating report, services being provided, duration of
the open Collaborative case, reason for case closure, and the number of cases per
month that involve families that have previously received services from the
Collaboratives.

• The Committee recommends that the Agency develop a budget format that
clearly explains and tracks the actual activities of the Agency. The Committee has
continued to express concerns about the format of the CFSA budget. The
Committee would encourage the Agency to work toward greater transparency
and clarity in its budget presentation. It is impossible, for instance, to
understand how funds are allocated for group home contracts, independent
living contracts, the Center of Keys for Life, and other Agency programs, within
the current budget format. It is impossible to discern how funds are tied to
outcomes or reflect policy and programmatic priorities.

2. Regarding the Intake/Investigations Unit please provide numbers for the following:
a. Total number of calls received to the Intake/Investigations Unit
b. Current number of open investigations
c. Total number of backlogged investigations
d. For the backlogged investigations, what is the length of time each has remained open
e. Total number of FTEs allocated for CPS
f. Total number of workers assigned to the CPS
g. Total number of vacancies
h. Number of vacancies the agency plans to fill

3. According to the Lashawn Implementation Plan, what is the required investigation/caseload

for Investigations Workers? For On-going Workers? What is the current caseload per
Investigation Worker? On-going Worker? Please provide the number of workers that have
caseloads above the required number, length of time that caseloads have been above the
required number and the unit each worker is assigned.

4. How long will joint review of Hotline calls between CPS and the Collaborative workers
continue? How many Collaborative workers are at Intake? Provide the number and percent
of investigations referred to the Collaboratives at the following referral points: Short Term
Crisis Support, Diversion, and Partnership for Community Based Services, Community
Cases. How are you measuring the effectiveness of this approach?

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

5. Currently, how many social workers are co-located with the Collaboratives?
a. What are the caseloads for these workers?
b. Are workers assigned according to geographic location?
c. How many families have been served since the co-location?
d. What impact has the co-location had on the ability of the agency to meet visitation
goals set forth in the AIP which the agency has struggled to meet?
e. What are the performance outcomes or benchmarks set forth for the co-location?
f. Has the agency developed an effective process for co-located workers to receive
funding for items such as cribs, furniture, and other emergency items for families?

6. According to the Lashawn Implementation Plan, what are the requirements for medical and
dental evaluation for youth entering care?

7. Provide the number and percent of children who entered foster care that received a health
screening prior to placement.

8. Provide the number and percent of children who entered foster care that received medical
and dental evaluations within 30 days of placement.

9. Please provide a status report on the newly implemented Healthy Horizons Assessment
Center. Please include performance outcomes or benchmarks to be achieved.

10. Please provide a full status report on the following programs. Please include project
description, performance outcomes or benchmarks to be achieved, total operating budget,
total number of workers and total number of families or youth served:
• Permanency Opportunities Program
• Parent Advocate Program
• Expansion of Healthy Families Healthy Start in wards 5,6,7, and 8
• Father-Child Attachment Pilot

11. Where are you in the process of restructuring the Office for Youth Development? Please
provide a copy of your restructuring plan to include specific changes to be made and a
timeline for completion and full implementation. When will the agency implement a website
for this program?

12. Please provide a program description, performance outcomes or benchmarks to be achieved,

how you measure the achievement of the performance outcomes or benchmarks, total
operating budget and total number of participants for the following program:
• College summit
• Life Skills Training
• Rites of Passage

13. Provide the total number of Educational Training Vouchers (ETV) requested and granted.
What are the eligibility criteria for being awarded an ETV? For each youth where a request
for an ETV was made and denied, provide the reason for denial?

14. Provide the total number of youth who completed the 2nd year of college.

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

15. Provide the total number of youth who completed the 4th year of college.

16. Provide the total number to youth enrolled in vocational school.

17. Provide the total number of youth completed vocational school.

18. Provide the total number of youth who participated in the summer employment program.

19. Provide a copy of the current residential care regulations?

20. Provide a timeline for when the agency will complete and disseminate a foster youth bill of
rights?

21. Please provide a program description, total budget per program, performance outcomes or
benchmarks to be achieved, the total number of youth receiving aftercare services, and the
length that services are provided for youth after care programs through the Healthy Families
Thriving Community Collaboratives.

22. What is the agency’s current penetration rate?

23. When does the agency anticipate claiming for enhanced training? What impact will this have
on the District’s Title IV-E reimbursement rate?

24. Does the agency plan to claim administrative costs for foster care candidates in an effort to
further maximize Title IV-E reimbursement? If yes, when do you anticipate the Agency will
begin claiming administrative costs for this population? What impact will this have on the
District’s Title IV-E reimbursement rate?

25. Provide a full overview of CFSA’s Medicaid reform effort.

26. What percentage of CFSA case carrying social workers have been trained on Medicaid
documentation and billing process? When will training of staff be completed? Will ongoing
training be a requirement for all case carrying workers?

27. Will CFSA case carrying social workers receive training on Title IV-E billing and
documentation requirements to ensure full federal compliance? Will ongoing training be a
requirement for all case carrying social workers?

28. Where is CFSA in the process of ensuring that all providers are Medicaid eligible? Please
provide a list of providers that are and are not currently Medicaid eligible. Please provide a
timeline as to when this process will be completed.

29. CFSA is currently working in collaboration with DHCF to submit an amended state plan.
When will the amended state plan be complete? Please identify the changes to be included in
the amended state plan?

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

30. Why did the agency make the decision not to resume Medicaid claiming? When was this
decision made? When will the agency resume Medicaid claiming for TCM and the Rehab
Option? Will there be a spending pressure as a result of this decision? What is the total
spending pressure amount? Will this spending pressure impact the delivery of services?

31. In the CFSA’s primary Title IV-E foster care review conducted by the Children’s Bureau,
Administration for Children and Families the following issues areas were identified and
recommendations made. For each recommendation please indicate whether CFSA will
implement the suggested corrective action. If the suggested action is not taken, please
identify what action will be taken and the timeline of the action.
• Unallowable Program Costs: The District should review its payment system to
determine whether adequate financial controls and edits are in place and properly
functioning to prevent payments for ineligible children or unallowable costs. An
automated quality assurance module should be included to periodically review
and track payments for accuracy and compliance with federal requirements.
• Placement and Care Responsibility: CFSA should review its automated system
to ensure that appropriate controls are in place to guarantee that children who
have achieved permanency are no longer receiving title IV-E foster care
maintenance payments. The District’s standardized court orders should be
revised to specify when CFSA has placement and care responsibility of a child
• Licensing: CFSA’s automatic system should be reviewed to determine if there
are adequate edits in place to prevent title IV-E from being claimed when a child
is placed in an unlicensed provider. Eligibility and licensing staff should work
together to ensure that current licensing information is shared and establish a
system for reviewing compliance with this requirement periodically.
• Safety Checks: The District’s licensing process should be reviewed to determine
whether there are sufficient controls in place to prevent children form being in
an unsafe foster home or childcare institution. A quality assurance process that
periodically reviews the safety check requirements for all foster homes and
childcare facilities should be instituted.
• Underpayments: The District is failing to claim all available title IV-E
reimbursement. Eligibility, licensing, fiscal, and systems staff should work
together to determine how to balance competing priorities.

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

32. In November 2009 the Center for the Study of Social Policy released a special study,
Assessment of the District of Columbia’s Child Welfare System: Practices to Support Children Who Enter,
Re-enter or are Re-placed While in Foster Care. The study yielded several findings and
recommendations. For each recommendation please indicate whether CFSA will implement
the suggested corrective action. If the suggested action is not taken, please identify what
action will be taken and the timeline of the action.
• FACES documentation and management reports were not consistently reliable:
CFSA must ensure that private agencies and CFSA staff strictly adhere to
FACES documentation protocols and requirements. A review of FACES
documentation practices is needed and prompt action must be taken to correct
identified issues. CFSA should develop and implement an annual independent
audit process to ensure the accuracy and validity of FACES data
• CFSA practices undermine placement stability for too many children: CFSA
should conduct an analysis of placement decisions during a defined period of
time to identify specific reasons why temporary or emergency placements are
made and then take action to reduce the use of these placements in all instances
where they are not absolutely necessary.
• Foster parents are not consistently receiving the information they need to care
for children, including Medicaid Numbers, Medicaid Cards and Placement
Packets: CFSA supervisors and managers should be held accountable to ensure
that all available and appropriate information is shared with foster parents upon
placement and the required Placement Packets, Medicaid Numbers and Medicaid
Cards are made available and given to foster parents within required timelines.
• The health and dental needs of children newly placed into foster care are not
consistently met: CFSA supervisors and managers and the Office of Clinical
Practice should be held accountable to ensure children receive medical and
dental evaluations within 30 days of placement.
• Visits to foster children in new placements need to occur more frequently:
Development of a consistent model/protocol of safety assessment is necessary
to ensure that each child’s safety is assessed at and documented for every visit.
• Foster parents are not consistently engaged as part of the team planning for
permanency for the children in their care: Foster parents must be well informed
about the permanency goal and engaged from “day one” in supporting
permanency for the children in their care.
• Family connections are not maintained for all children with a goal of
reunification: Increased attention should be given to ensuring that clearly
understood and feasible family visitation plans are in place for every child placed
in foster care and are established as soon as a child is removed form their home,
unless there are safety or other appropriate reasons to limit such visits.
• Many foster parents believe that services and supports are not at a level of
intensity necessary to meet children’s needs: Therapeutic supports need to be
individualized and readily available to children in foster care. Foster parents
should fully be apprised of the availability of services and involved in the
planning for children’s needs.

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

33. In the FY 2010 budget report, the Committee directed the agency to submit plans for the
implementation of a performance based-contract model before any Request for Proposals
(RFP) are released. Where is the agency in the process of implementing a performance-
based contract model? Please explain the reason for delaying implementation? When will
Request for Proposals (RFP) be released? Is the agency planning to use human care
agreements? Will benchmark measures be reflected in the human care agreements? What
benchmarks are you incorporating in the agreements? Please provide a written copy of your
implementation plan.

34. Provide the Committee with the per slot cost of each contract by provider.

35. Provide the most current data on the average time a child remains in foster care by provider.

36. Provide data on the timely achievement of permanency outcomes for each contract by
provider.

37. Provide the number of unusual incident reports in foster homes, group homes and
residential treatment facilities by category of report.

38. Provide the number of children in abscondence in the care of CFSA and by private agency
and the length of time each has been in abscondence.

39. Provide the number and percent of children in foster care with the permanency goal of
adoption in an approved adoption placement within 9 months of the goal.

40. How many children entered and exited foster care by category?

41. Provide the number of children in foster care by permanency goal and by age for all
permanency goals.

42. Provide the number of children who entered foster care that requested and received mental
health services by age. What was the average time between the request of services and the
delivery of services?

43. Provide the number of children that were and are currently placed in unlicensed foster
homes.

44. Provide number and percent of foster children who within the previous 12 months have had
(a) 2 or fewer placements; (b) 3-4 placements; (c) 5 or more placements.

45. Provide the number and percentage of foster homes in D.C. versus Maryland and Virginia
by provider.

46. Provide the amount of foster care subsidies provided for foster parents in the District,
Maryland, and Virginia.

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 Child and Family Services Agency
Fiscal Year 2010 Performance Oversight Questions (Round 2)

47. Provide the total number of youth ages 13-21 in foster care by age, gender, and permanency
goal.

48. Provide the following by age, gender, race, provider, location, daily rate and time in care:
• Total number of youth living in group homes
• Total number of youth living in independent living programs
• Total number of youth living in residential treatment centers

49. Identify the providers who have been placed on probation following your contract
evaluation process. Identify what performance measures were not met that lead to their
probation. When will the probationary period begin and end for each?

50. Identify the contracts that have been terminated, what services were being provided, when
the contract was terminated and reason for the contract termination.

51. In Q-39 submitted to the agency in the first round of questions, please provide the following
additional information where applicable:
• The nature of the MOU, including performance outcomes or benchmarks
• The dollar amount of the MOU, including budgeted amount and actually spent
• The term of the MOU
• Funding source
• Total number of families and youth served

52. Has the agency finalized its city-wide child abuse and neglect prevention plan? If yes, please
provide a copy of the plan.

53. How many family and youth profiles have been placed on the Adopt DC Kids Adoption
Registry? Is this a tool that social workers within CFSA and the private agencies actively
utilize?

54. What are the agency’s recruitment targets for increasing the number of foster care homes in
the District? What strategies have been implemented to accomplish these targets?

55. What has been the agency's progress in identifying homes and placements that will provide a
safe and positive space for LGBTQ foster youth? What have been the barriers? What are
your targets for the fiscal year?

56. What specific strategies have been implemented to address the specialized needs of youth
with intellectual and other developmental disabilities that do not meet the eligibility criteria
for DDA and are transitioning out of care?

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