State Innovations in Child Welfare Financing. California: Project DESTINY

04/01/2002

Alameda County Department of Children and Family Services’ Project DESTINY (Demonstrating Effective Strategies for Intensive Placement Youth) was first implemented in 1997 as a small pilot project to support children living in group homes and residential treatment, and attempt to move them to the least restrictive environment whenever possible. The pilot project was expanded in 1999 as part of the California Title IV-E Child Welfare Waiver Demonstration Project – Intensive Services Component. Under the waiver, federal title IV-E funds may be used flexibly to pay for services not traditionally covered by title IV-E.

The project targets children between the ages of six and seventeen who:

  • Are in highest level of care group homes, whose placement is disrupting, and who are likely to be placed in another high level residential facility;
  • Are below age ten and who are living in group homes;
  • Are probation wards between the ages of 10 and 14 and living in group homes;
  • Are entering placement and are referred for a high level of care group home;
  • Require 24-hour supervision to ensure safety;
  • Need intensive services for more than six months; or
  • Require short-term intensive hospitalization or hospital alternative assessment and diagnostic services.

Alameda County contracts with three private agencies (Seneca Center, Lincoln Child Center, and Fred Finch Youth Center), collectively called the FlexCare Consortium, to provide case management and wraparound services to eligible children. Generally, the county screens every high-level group home referral to determine whether the child is eligible for Project Destiny. If eligible, the case is referred to the FlexCare Consortium for review and randomly assigned to one of the three private agencies. Currently, the three agencies serve approximately 90 children. However, the county has appropriated funds to serve 256 children over the entire waiver period.

Service providers use a child and family team model to engage families and their natural support systems (i.e., extended family, neighbors, and friends) in service planning and delivery. Flexible funding enables providers to deliver an array of services such as parent advocacy, social and recreational rehabilitation in the community, 24-hour crisis response, respite, parenting skills activities, individual and family therapy in the home or community, and collaboration between community agencies, family, and mental health counselors.

The county reimburses providers a capitated rate of $4,082 per child per month, for a two-year period. During that time, providers remain responsible for delivering all services that the child may need regardless of the placement setting. Hence, the payment system encourages providers to deliver services in least restrictive community settings and to minimize the length of stay in high level and expensive residential treatment.

Case oversight is provided through the Case Management Workgroup, which is composed of both county and FlexCare case management staff. This group meets weekly to discuss ongoing cases and review new referrals. In addition, the University of California-Berkeley has been engaged to conduct an experimental evaluation of the project. UC Berkeley will rely on Department of Children and Family Services’ administrative data, a number of family assessment tools, and in-depth family interviews to evaluate the project.

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