State Innovations in Child Welfare Financing. Washington: Title IV-E Waiver Demonstration Project


The Children’s Administration of the Washington State Department of Social and Health Services (CA) initiated this demonstration project in an attempt to provide more services to children in the state child welfare system at home (if possible) and within their communities. In order to achieve this goal, the CA made blended, flexible funds available to cover the cost of services, which included both basic and specialized services. The target population for this initiative were children in the child welfare system who were between the ages of eight and seventeen and in need of high-cost mental health and special education services.

The demonstration project was active in one region of the state (Spokane County). The CA had a contract with the Regional Support Network (RSN) to provide a wide range of residential, in-home, and follow-up services.

The RSN established a sub-contract with a local provider to manage the actual service provision. This provider then developed its own sub-contract with another agency to facilitate the Individualized and Tailored Care (ITC) teams. The ITC teams consisted of staff from the state, county, and providers where treatment plans were developed. These teams involved the foster parents and, where appropriate, family members in the discussions. The local provider had hoped that by sub-contracting out the facilitation of the ITC teams it could make case management more efficient and cost-effective. However, it was not able to achieve these efficiencies and its services sometimes overlapped with those of the sub-contractor.

This demonstration project was terminated after six months in November 2000. The local provider assumed the financial risk and during the course of the project it lost approximately $250,000. The RSN initially received $2,400 per child per month but this was quickly raised to $2,550 once it became clear that the sub-contractors were losing large sums of money. However, the local provider estimated that the services they were providing cost $4,800 per month. One problem that was highlighted in the final evaluation by the state was that the Children’s Administration believed that the RSN would free up some internal funds to complement the other flexible monies available for the children but the RSN denies that they ever agreed to do this. The evaluation notes that there was “insufficient communication” between state and county administrators and that this adversely affected the achievement of program goals.

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