State Innovations in Child Welfare Financing. Kentucky: Quality Care Initiative


Kentucky’s Quality Care Initiative started in early 2000 after an extended dialogue between the Mary Hearst agency and the state Department of Community Based Services. This pilot project is currently only available in Jefferson County. Under this initiative the agency is given a case rate and is expected to achieve designated permanency goals for the children. There is a stop-loss provision in order to limit potential losses to the provider. The provider covers any loses up to 125% of the case rate and the state covers any additional costs beyond that point.

The program is designed to serve three distinct target populations: teenage girls in need of residential placement; children in the foster care system who are transitioning home; and children who have just entered foster care in the last 45 days. At the time of the interviews with QCI staff, there were 5 youth from population 1, 21 youth from population 2, and 5 youth from population 3. There are no immediate plans to increase the number of youth involved in the program. The total number of youth served for the course of the program is 60.

This initiative has increased the provider’s involvement in the decision-making process. The provider determines the level of services that they offer to the family and they also attend court hearings to give reports on case progress. According to the provider administrator, the main advantage for this program is the additional freedom to provide wraparound services rather than the strictly prescribed services that are offered by other state programs.

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