State Innovations in Child Welfare Financing. Georgia: Metropolitan Atlanta Alliance for Children (MAAC)


Children in the Atlanta region who are not eligible for Georgia’s program for Severely Emotionally Disturbed (SED) children are referred to Metropolitan Atlanta Alliance for Children (MAAC). Established in 1998, MAAC is an MCO that contracts with a network of providers to deliver a range of services. In addition to residential treatment and foster care, providers in the MAAC network also deliver reunification and adoption services. The range of levels of care provided by the network members enables MAAC to move children out of high levels of care more quickly than would be possible if only the agency providing the intensive care were managing the case. Over the past year, MAAC served approximately 30 children and its capacity was recently expanded to serve 40 children.

MAAC is responsible for placing referred children with a network provider according to the level of care that is needed, and remains responsible for providing care until the case is closed. Referrals to MAAC are reviewed by a six-member professional committee made up of representatives from each of the six provider agencies. This committee determines the level of care that the child needs and assigns the case to a network provider. The placement decision is made by consensus among the six-member committee. For children in state custody, the service agency caseworker, the state child welfare worker, and any other professional assigned to the case attend all case staffings and court hearings.

Rather than increasing the array of services that any one provider delivers, the effect of MAAC has been to make available a wider array of services to any child served by the network. Through the provider network, children can more easily move between levels of care and service. Furthermore, because providers can rely on each other for support services, placement disruption is less likely. For instance, the network’s intensive in-patient hospital provides short-term stabilization for network members’ clients. Otherwise, the hospital only provides long-term care in chronic cases. As a result of this collaborative effort among network members, individual providers are more willing to maintain care for a child for longer periods because the other providers are more available to them if short-term supportive services are needed to avoid placement disruption.

The state pays MAAC a flat per diem rate of $159.60 for each child referred to the network by Match. MAAC then pays the provider at the following per diem rates that are set by the state: basic care $70-80, intermediate care $133 to $230, and intensive care $313. Hence, the payment system imposes a financial incentive for MAAC to avoid placing children in higher-level, higher-cost care and to keep the length of stay in this type of care to a minimum.

MAAC’s administrative entity has taken on the financial risk of the network arrangement since member agencies also receive referrals from other sources that pay the same per diem rate. Hence, the providers can survive financially without MAAC, but the administrative component of MAAC can’t survive if it overspends its budget. As it is, the state per diem only covers services provided by network members, not MAAC’s administrative costs. MAAC conducts private fundraising efforts to pay its administrative costs.

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