Child Welfare Rate Setting & Financial Analysis

Louisiana Department of Children and Family Services
Time Study

From 2016 to 2017 HZA was contracted by the Louisiana Department of Children and Family Services to conduct a rate time study to establish well documented rates for residential facilities, non-medical group homes and therapeutic foster care for DCFS to use to reimburse providers and maximize federal reimbursement. The study explored the components of each rate and alternative rate structures. Empirical cost and time study data was collected from the services providers. The results are used to justify rates for federal reimbursement.


Clark County, Nevada
Title IV-E Waiver Evaluation Cost Consultant

From 2015 to the present, HZA is serving as a sub-contractor in Clark County, Nevada (Las Vegas) to provide consultation for the Cost Analysis for its Title IV-E Waiver. HZA’s specific role is to identify and recommend mechanisms to monitor cost effectiveness, define successful cases, collect outcome data on the treatment and comparison groups, identify the rates of success and factor that into the average cost of a successful case. HZA is working as a subcontractor to Baldacci Consulting Group.


Alaska Department of Health and Social Services
Mulgrew v. State of Alaska

From 2012 to 2013, in response to a court finding in Mulgrew v. State of Alaska HZA evaluated the rates the State pays foster parents, recommended new rates where needed and estimated the financial impact. The project resulted in proposed updates to the three components of the foster care rate structure: base rates, special needs payments and augmented rates. From 2015 to 2016 HZA assisted the State Department of Law in the role of expert witness to defend Alaska’s rate structure.


Mississippi Department of Human Services
Financial Assessment

From 2010 to 2012, as part of a consent decree, HZA was contracted by the Center for the Support of Families, Inc. to conduct a financial assessment for the state of Mississippi to determine the degree to which additional federal funding could be claimed to support child welfare programs. HZA conducted a comprehensive assessment of the practices used to secure Title IV-E funding for maintenance costs, administrative expenditures and training as well as to claim Title XIX for medical-related services. HZA’s recommendations have been tracked by the court monitor to assure state compliance.


A follow-up contract to 2014 allowed HZA to develop several software tools for Mississippi to use in performing both retroactive and on-going claims. These included a Random Moment Sampling (RMS) Calculator to assist DFCS in processing the results from the quarterly Random Moment Sampling (RMS), taking into account recently implemented changes to its RMS process. Using case-specific responses to the RMS, the tool is designed to automate the matching process to MACWIS eligibility statuses to identify the random moment hits or the proportion of time in which RMS participants were involved in federally reimbursable activities performed for Title IV-E clients. HZA also developed a Pre-service Training Calculator to assist the agency to identify the portion of its training hours and activities which satisfy the Title IV-E training criteria. The final tool allows Mississippi to submit retroactive claims for costs incurred before the child was determined to be Title IV-E eligible.


Washington Department of Social and Health Services
Washington Foster Care Rate Redesign Project

In 2012, HZA was retained by the Washington Attorney General’s Office to provide expert witness services in the matter of rate setting for FPAWS v. Dreyfus, et al. litigation. HZA’s written report examines how the state’s initial foster parent rate setting methodology was created and assesses the degree to which the system covers all reimbursable costs. In addition, the report examines the methods used by various external groups to define appropriate rates of payment for foster parents. HZA is supporting the report with expert testimony. In 2000, HZA developed a system for setting foster care rates for children in foster care who exhibited above average needs. The system focuses on the needs of the child, providing additional reimbursement when foster parents agree to spend extra time or money to address those needs. About a year after implementing the system, the agency asked HZA to develop a similar system for the Voluntary Placement Program, which served developmentally disabled children who cannot live at home. The two systems were coordinated, with the basic and first level of additional need and payment being identical, because the child welfare and developmental disability units of the agency often used the same homes.


Nevada Department of Health and Human Services
Project Management and Cost Allocation Plan for Organizational Restructuring

From 2002 to 2004, HZA assisted the Department in restructuring child welfare services based on new legislation. Child protective services in the two largest counties, Clark (encompassing Las Vegas) and Washoe (encompassing Reno), had been provided by county staff and funding with little involvement at the state level. Once the child was placed into foster care and adjudicated, however, responsibility shifted to the state. The passage of new legislation in 2001 created a unique situation in which the State’s entire child welfare system would be county administered in the two large counties but state administered elsewhere. Playing a major role in the management of this change, HZA worked closely with state executives to re-draft the State’s child welfare regulations, revise the federal cost allocation plan, and redesign processes such as eligibility determination to reflect the organizational shift.


New Jersey Department of Children and Families
Restructuring Rates for Foster Families, Shelter Care, Contracted Foster Care and Regional Diagnostic and Treatment Centers

In four separate projects HZA developed methodologies for setting rates the state would pay to various providers delivering the same service, such as shelter care or diagnostic and treatment services for children in foster care. HZA based the rates on program standards established for each service and the costs reported by providers, averaged across service type.


Alabama Department of Human Resources
Revenue Enhancement/Rate Setting System

HZA developed a formula to identify and apply administrative and training costs as a revenue maximization strategy to enhance Title IV-E revenues and recovery of prior state expenditures eligible for federal funding. The scope of work was later expanded to include development of a rate setting system for children in residential and group care.


Georgia Department of Human Services
Title IV-E Penetration Rate

HZA conducted an assessment of the potential for increasing the Title IV-E penetration rate among foster children and to assist in identifying other ways to increase federal funding. The assessment examined DFCS practices in relation to federal Title IV-E regulations in three areas: cost allocation, eligibility determination and program policies. The cost allocation component included an analysis of the federally approved cost allocation plan and how it was being implemented. The eligibility determination component involved an examination of 200 eligibility determinations and 50 redeterminations to determine which factors caused negative determinations, e.g., income, deprivation, court actions, home/facility status. The policy assessment focused on relatives as caregivers and candidates for foster care. The study resulted in seven recommendations for increasing the penetration rate and other ways to maximize federal funding.


Utah Department of Human Services
Technical Assistance on Revenue Enhancement

HZA assessed the current practices for collecting federal reimbursements as performed by the Division of Child and Family Services of the Utah Department of Human Services.