September 10, 2004
The Texas Department of Family and Protective Services (DFPS) Advisory Council met at the John H. Winters Building, Public Hearing Room, 701 West 51st Street, Austin, Texas. Council Members present were Chair Richard S. Hoffman and Members Dr. Ronald Brandon, John Castle, Anne Crews, Catherine Clark Mosbacher, Imogen Papadopoulos, Ommy Strauch, and Gerry Williams. A quorum was present. Also present were Commissioner Thomas Chapmond and Department staff.
Agenda Item 1 - Call to Order
Agenda Item 2: Reading, Correction, and Approval of Minutes of July 9, 2004.
Motion was made and seconded. Approval was unanimous. The motion carried.
Item 3 - Public Testimony
Ms. Mosbacher stated she had invited Mr. Gene Daniel to appear and speak. Mr. Daniel served as CPS Regional Director for Houston, has retired from that position but is still involved in Family and Protective Services as a consultant on a national basis, with an expertise in accreditation.
Mr. Daniel spoke about the Council of Accreditation (COA) for Family and Children Services and the need for Texas to enter the accreditation process. He stated that he is a volunteer for the Council and serves on a commission for the Council to determine which agencies get accreditation. The Council began in 1977 as a program of the Child Relief of America and Family Services Association to serve as a third-party to handle program accreditation. Currently 1,600 organizations are accredited by the Council in the United States and Canada. In Texas about 30 private organizations are accredited by the Council.
The Council addresses such issues as supervision, supervisor-to-worker ratio, caseloads, staff training, and staff turnover. Mr. Daniel further stated that the Council standards match the federal standards, and the standards emphasize outcome measures and continuous quality improvement measures. The accreditation fee is minimal, and the majority of cost for most states is to enact the changes needed to meet the standards. Mr. Daniel asked that the Advisory Council to encourage the legislature to consider entering the accreditation process.
Mr. Hoffman asked how many states are accredited by the Council; Mr. Daniel replied 10 statewide programs are accredited or in the process of accreditation. He added that most states that become accredited then require all their contractors to be accredited as well.
Ms. Mosbacher asked for more details on the cost. Mr. Daniel explained that accreditation is a process, not just a one-time application, in meeting the standards. Cost is whatever it takes to meet standards. It is really a self-study process of the standards that takes one year to review. A state as large as Texas generally would accredit by office and region until 60% of the state has been accredited, at which time the whole organization would be accredited.
Dr. Brandon asked if fees for accreditation are just the tip of the iceberg, and expressed concern that accreditation would add another level of oversight and preparation for inspectors that would take the organization away from the mission of serving children. Mr. Daniel replied that licensing standards track the COA standards and noted that other states have passed laws that allow accreditation to substitute for state licensing. He said that Texas had tried that approach once before but it failed because the private providers wanted to use their own accrediting body, which didn’t develop effective standards.
Mr. Chapmond noted that the biggest challenge to Texas is the caseload standard. According to Mr. Chapmond, FPS would need to add 1,800 workers to meet the standard. Mr. Daniel noted that when caseloads exceed the standards, the workers are not serving the children well.
Ms. Mosbacher asked for clarification whether Texas had been previously accredited. Mr. Daniel replied that Harris County was accredited until 1994, but the state had never been accredited.
Ms. Mosbacher invited Ms. Papadopoulos, former president of Harris County CPS Board, to speak. Ms. Papadopoulos noted that the cost would be a major issue, and asked Mr. Daniel if he had an estimate of the additional costs to the FPS to begin meeting the standards. Mr. Daniel said that he did not have an answer, but that Mr. Chapmond’s staff had done a review that included cost. Mr. Chapmond stated he thought the figure would be more than $200 million.
Ms. Papadopoulos asked if there had been any longitudinal studies on cost effectiveness. Mr. Daniel said that studies indicated an improvement in services, and that his own experience had shown that accreditation improved worker morale and practices. Mr. Chapmond added that accreditation would likely decrease turnover and improve quality of work.
Ms. Mosbacher asked about the education requirements for accreditation and whether the universities would be set up to accommodate them. Mr. Daniel replied that it was a matter of commitment within the organization to insist that those who want to remain supervisors obtain the required education.
Mr. Mike Foster addressed the Council about three issues. First, Mr. Foster stressed stakeholders need to be involved from the beginning in setting the agenda, not just responding to a preset agenda. Second, Mr. Foster stated he did not believe the outcomes set, particularly the goal of placing children close to their homes, were fair and reasonable, and he suggested setting a baseline and measuring improvement against that. Third, Mr. Foster said he did not feel that the agency had advanced in the delivery of treatment and care during the past year, and asked the Council to address the lack of improvement. Mr. Foster expressed his support of accreditation.
Agenda Item 4 - Staff Briefings
Mr. Hoffman recognized Caroline Bivens, Division Administrator of Policy and Innovation, who is returning to school to pursue her Master’s degree.
4.a. Commissioner’s Report - Thomas Chapmond
Mr. Chapmond noted the agency is dealing with several legislative issues. Among these is testimony to the House Human Services Committee on proposed solutions to perceived problems; and to the House Select Committee on Child Welfare and Foster Care, which is scheduled to meet again in early October to examine several issues, including the impact of foster children on schools.
Stakeholders met earlier in the week to discuss the Legislative Appropriations Request (LAR). The Adult Protective Services review final report is due on November 4. A series of reforms were presented at the advisory committee work session, and these reforms will be implemented prior to the report. The Child Protective Services 90-day report will be released on September 29. The report focuses on the agency’s compliance with its own rules and laws as well as case management. The report is the first phase of the CPS review; the second phase will be initiated by Commissioner Albert Hawkins, who will invite national organizations to recommend best practices that will meet the specific challenges facing the agency.
Mr. Chapmond concluded by introducing new staff members: Gerry Williams, Acting General Counsel, and Deborah Wanser, Assistant Commissioner for Adult Protective Services.
4.b. Legislative Appropriations Requests - Cindy Brown
Cindy Brown reviewed the LAR status. On Sept. 3, the Legislative Budget Board provided the control totals for each agency’s request, which took into account the required 5% reduction. The LBB’s calculation matched the agency’s request, but it did not account for caseload growth; caseload growth must be requested as an exceptional item. Ms. Brown stated that the agency is continuing to work with Health Human Services Commission (HHSC) on how to split out the caseload growth between the base request and the exceptional items. According to Ms. Brown, the General Revenue control total is not sufficient to fund caseload growth, which means the agency will need to reduce rates for foster care and payments for adoption subsidies in the base request and ask for restoration in exceptional items.
Ms. Mosbacher asked if caseload growth would be an exceptional item for everyone, and Ms. Brown replied it would be a consistent approach for agencies under Health and Human Services. Ms. Mosbacher asked where the decision came from, and Ms. Brown replied she thought it was from the legislative leadership office, who wanted to see the impact of caseload growth on the budget. Ms. Mosbacher asked for confirmation of where the decision was coming from to determine whether it was a policy of the Governor, of the Commission, or another entity. Ms. Brown said she believes it is coming from the House Appropriations Committee.
Mr. Chapmond added the letter with the decision came from the Legislative Budget Board. Mr. Hoffman asked whether the assumption was that the decision was made in part to see the impact of caseload growth. Ms. Brown replied that she thought House Appropriations and Senate Finance wanted to see what caseload growth will cost and the easiest way is to make it a separate item.
Ms. Brown reviewed list of exceptional items. Ms. Mosbacher asked Ms. Brown to review the items on the exceptional items list in more detail and suggested a work session on the issue. Mr. Chapmond stated that there is an information packet with more detailed information about the budget and offered to provide Ms. Mosbacher with the packet.
Ms. Strauch asked about the budget process, whether the Council would get a response to the agency’s response, and the timing for contacting the appropriate people about the budget requests. Ms. Brown replied the first public hearing, the Joint Budget Hearing, would be at the end of September. After the agency submits its LAR, it goes to the LBB and the Governor’s Office. They each prepare a budget recommendation, which is usually released in late December. That will be the first opportunity for the agency to react to the funding options.
Mr. Chapmond added that the appropriation’s request is changing almost daily due to new rules or directions. The current document was prepared on short notice to share with stakeholders. The agency did not feel that they could put together an accurate, detailed document with the constant changes, which is why the Council received a high-level document rather than the detailed document. The Council will receive the more detailed packet prior to its submission to the LBB on September 22. The agency had prepared and prioritized the list of exceptional items, but the list may change as the agency works with the various leadership offices to determine legislative priorities.
Ms. Strauch asked again for clarification on the role of the Advisory Council in the appropriations request process and the timing for their response. Mr. Chapmond replied that the role of the Council members is to work within their local communities and with their leadership offices.
Dr. Brandon requested more details on the individual programs on the exceptional items list. Mr. Chapmond assured the council members they would receive more detailed information.
Mr. Hoffman asked what the CPS caseload would be if the legislature were to approve all the exceptional items. Mr. Chapmond responded that during the previous budget, CPS had to reduce staff while maintaining caseloads, and he did not think it was possible to ask the legislature for the additional $200 million to add the 1,800 workers needed to reach the caseload standard. Mr. Chapmond is confident that after the CPS review there would be a request from the Commission for additional resources to reduce caseloads. Mr. Hoffman asked whether reducing caseloads would make the greatest impact on services in CPS, and Mr. Chapmond stated that caseloads would be his greatest priority. Changes in requirements have added paperwork for caseworkers and that the extra workload has had a negative impact on quality of service.
Dr. Brandon asked whether the APS review had indicated any areas for additional funds. Mr. Chapmond replied they need to add caseworkers, but cautioned that simply adding workers isn’t enough. The agency needs the resources to train and supervise the additional caseworkers. Mr. Chapmond also explained that both APS and CPS are changing the method by which they measure caseloads. Dr. Brandon also asked whether the priority of adding caseworkers also includes adding supervisors, and Mr. Chapmond replied it did include supervisors as well as additional support staff.
Ms. Mosbacher asked whether the packet of detailed information would include a narrative about the increase in caseloads and the recommended caseloads. Ms. Brown replied that the packet includes a narrative for each of the exceptional items, and those narratives will indicate which items are related to reducing caseloads, but the packets would not address caseload reduction as a separate item. Ms. Mosbacher suggested that a narrative on caseload reduction be included, and requested future dates for deadlines and opportunities for comment.
Ms. Lund asked about interest in prevention programs. Mr. Chapmond replied that the agency and the legislature have a great interest in prevention programs, but by necessity, the limited resources are directed to children needing immediate care.
Dr. Brandon inquired about the need to hire more investigators. Mr. Chapmond agreed there is a need for more investigators but the current appropriations request does not include funds for that.
Ms. Mosbacher requested clarification on the process and whether Commissioner Hawkins would see the response to the LBB before it is submitted. Ms. Brown replied that they are not required to submit the final draft to Commissioner Hawkins before sending it to LBB, but he is aware of what is happening.
4.c. Child Care Licensing - Diana Spiser
Diana Spiser updated the “Look Before You Leave” campaign concerning children becoming sick or dying after being left in vehicles. In 2003 Texas led the nation in such fatalities; three of the fatalities were at child care facilities. The campaign ran from Memorial Day to Labor Day 2004. Materials were sent to child care facilities and foster homes as well as billboards and radio spots reminding parents and caregivers to look for children in the vehicle before leaving.
Ms. Spiser introduced and thanked the people who worked on the campaign. Mr. Chapmond with presented with the Safety Star Award on behalf of the staff.
Dr. Brandon asked about expanding the campaign to include eldercare facilities. Ms. Spiser replied that much of the campaign could be adapted for use with the elderly.
Ms. Strauch asked about the funding source for the campaign. Ms. Spiser replied that federal funds were identified to supplement child development funds.
Agenda Item 5 - New Business
5.a. Consideration to publish for public comment amendments to 40 TAC, Section 720.550 concerning program staff, Section 720.553 concerning admissions policies, and Section 720.560 concerning the environment in therapeutic camps - Diana Spiser
Ms. Spiser asked the council members to consider changes regarding therapeutic camps. She requested that the Council recommend to Commissioner Chapmond and Executive Commissioner Hawkins that the rules and changes be published in the Texas Register for public comment.
Ms. Mosbacher moved that the Council recommend for proposal by the Health and Human Service Commission the repeal, new rule, and amended rules concerning therapeutic camps as reflected in the Council’s September 10, 2004, Agenda Item 5a. Dr. Brandon seconded the motion. Approval was unanimous. The motion carried.
5.b. Consideration to publish for public comment amendments to 40 TAC, Section 700.522, concerning audiotaping or videotaping first contacts with alleged victims of physical or sexual abuse - Joyce James
Joyce James asked the Council members to consider changes to the rules for audiotaping or videotaping interviews with alleged victims of physical or sexual abuse. They are requesting that the number of exceptions be reduced from eight to four and that the language be clarified to reflect the intent of the law. She requested that the Council recommend to Commissioner Chapmond and Executive Commissioner Hawkins that the rules and changes be published in the Texas Register for public comment.
Mr. Castle moved that the Council recommend for proposal by the Health and Human Service Commission the rule concerning audiotaping and videotaping alleged victims of physical and sexual abuse as reflected in the Council’s September 10, 2004, Agenda Item 5b. Ms. Strauch seconded the motion. Approval was unanimous. The motion carried.
Agenda Item 6 - Update of Previous Business Before the Council - Thomas Chapmond
At the July 9, 2004 meeting, the Council recommended the publication in the Texas Register of two rules: one to amend rules concerning remedial action for falsification of records, and one concerning a rule to change an allegation disposition from moved to unable to complete. No comments were received on these rules. Acting General Counsel Gerry Williams forwarded these rules to the Health and Human Services Commission Friday with the recommendation that they be adopted as presented and published. No changes were recommended and it is anticipated that HHSC will adopt the rules.
Mr. Chapmond thanked the Council members for all their support and dedicated work. Mr. Hoffman extended appreciation to Mr. Chapmond for his leadership, especially at this last public Council meeting before he retires.
Mr. Hoffman asked for volunteers for a small group to meet with Commissioner Hawkins to propose changes to the rules for the advisory councils. Ms. Strauch, Ms. Papadopoulos, and Dr. Brandon indicated interest.
Agenda Item 7 - Meeting Adjourned.