Washington State

House of Representatives

Office of Program Research

BILL

ANALYSIS

Early Learning & Human Services Committee

SSB 6013

This analysis was prepared by non-partisan legislative staff for the use of legislative members in their deliberations. This analysis is not a part of the legislation nor does it constitute a statement of legislative intent.

Brief Description: Concerning behavioral rehabilitation services.

Sponsors: Senate Committee on Ways & Means (originally sponsored by Senators Frockt, Darneille, Keiser, Palumbo, Kuderer and Hasegawa).

Brief Summary of Substitute Bill

  • Requires the Department of Social and Health Services and the Department of Children's, Youth, and Families to convene a stakeholder workgroup to design a Behavioral Rehabilitation Services (BRS) rate payment methodology that is based on actual provider costs of care and submit a report on the workgroup's findings to the Legislature by November 30, 2018.

  • Requires the Caseload Forecast Council to forecast the number of youth expected to receive support and treatment from BRS while involved in the foster care system.

  • Requires that expenditures for BRS placements be forecasted and budgeted as maintenance level costs.

Hearing Date: 2/21/18

Staff: Luke Wickham (786-7146).

Background:

Operating Budget.

A two-year biennial operating budget appropriates funding for the operation of state government and is adopted every odd-numbered year. Supplemental budgets frequently are enacted in each of the following two years after adoption of the biennial budget.

Although many elements of the budget process are contained in statute, others elements of the process reflect decisions made by the executive and legislative branches. In Washington, budget decisions are often categorized as being either a maintenance level or a policy level decision.

For the purposes of the four-year outlook, maintenance level has been defined to mean the estimated appropriations necessary to maintain the continuing costs of program and service levels either funded in the prior biennium or otherwise mandated by other state or federal law. Maintenance level items typically include adjustments for the forecasted changes in entitlement caseloads/enrollments and other mandatory expenses.

All other budget decisions are typically categorized as policy items. Examples include:

Temporary Out-of-Home Placements.

If a Child Protective Services (CPS) social worker who responds to a report of child abuse or neglect determines that the child is unsafe in the home, the child may be removed and placed in a temporary out-of-home placement until he or she can return to the home safely or be placed in another safe and permanent living arrangement. There are multiple types of temporary out-of-home placements including:

Behavioral Rehabilitation Services.

The BRS are designed to be temporary, intensive services that utilize a wraparound service approach for youth with high-level behavioral, medical, or mental health issues. Most BRS youth are served in out-of-home placements in congregate care settings or with specially trained foster families. However, some support and treatment from BRS may be provided as an in-home service. Contracted vendors provide BRS at monthly all-inclusive rates. On a case-by-case basis, the Department of Social and Health Services (DSHS) may enter into child-specific contracts with BRS vendors to provide rates that exceed the regular rate table. Regional DSHS BRS managers act as the gatekeepers for BRS referrals.

Two assessments are currently used for children in the BRS program. The Children's Functional Assessment Rating Scale must be completed by the BRS vendor for most youth within 14 days of BRS entry and within 30 days of exiting the BRS program. The Wraparound with Intensive Services (WISe) screen is completed upon BRS referral and every six months during the youth's BRS stay to determine if the youth meets the eligibility criteria for WISe.

The child welfare services performed by the DSHS will transfer to the Department of Children, Youth, and Families on July 1, 2018.

Caseload Forecast Council.

The Caseload Forecast Council (CFC) is a state agency charged with preparing official state forecasts of the number of persons expected to meet entitlement requirements and to require the services of certain public assistance programs, including foster care, adoption support, the prison population, K-12 students, Medicaid, and other specified programs. The CFC itself consists of two individuals appointed by the Governor, and four individuals, one of whom is appointed by the chairperson of each of the two largest political caucuses in the Senate and the House of Representatives.

Budgeting Processes for Child Welfare Services.

Funding for some child welfare services are adjusted annually in maintenance level of the budget on the basis of actual and forecasted caseloads and per-capita costs. The DSHS child welfare services for which funding is currently adjusted in maintenance level of the budget in part using current caseload forecasts are:

Funding for BRS and for visitation services was adjusted in maintenance level through the forecast process until the 2009-11 biennial budget and 2010 supplemental budget, respectively, when the Legislature chose to begin treating all funding changes for these items as policy decisions.

Funding for staff including CPS workers is not adjusted annually in maintenance level on the basis of actual and projected workload.

Summary of Bill:

Behavioral Rehabilitation Services Rate Payment Methodology Workgroup.

The DSHS and the DCYF must convene a stakeholder workgroup in a collaborative effort to design a BRS rate payment methodology that is based on actual provider costs of care. The workgroup may consider the findings of a contracted rate analysis in designing the methodology. By November 30, 2018, the DCYF must submit a report with the workgroup's findings to the appropriate legislative committees.

Caseload Forecast Council.

The CFC must forecast the number of youth expected to receive support and treatment from BRS while involved in the foster care system.

Behavioral Rehabilitation Services as Maintenance Level.

Expenditures for BRS placements must be forecasted and budgeted as maintenance level costs.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.