Government of the District of Columbia

Child and Family Services Agency

Testimony of
Roque R. Gerald, Psy.D.
Director

Mayor Fenty’s Proposed

FY 2011 Budget for CFSA

Committee on Human Services

Tommy Wells, Chair
Council of the District of Columbia

April 22, 2010

John A. Wilson Building

1350 Pennsylvania Avenue, NW
Hearing Room 412
Washington, DC 20004
1 p.m.

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Good afternoon, Chairman Wells and members of the Committee on Human Services. I am Dr.
Roque Gerald, director of the DC Child and Family Services Agency (CFSA).

Mission
CFSA’s mission is to improve the safety, permanence, and well being of abused and neglected
children and to strengthen troubled families in the District of Columbia.

Like all public child welfare agencies, CFSA is responsible for four core functions:
• Investigating reports of child abuse and neglect and acting to protect children;
• Helping families to remain intact, whenever possible, while assisting them in
overcoming difficulties that place their children at risk;
• Providing temporary placement in foster care for children who cannot remain at home
safely; and
• Achieving timely permanence for all children and youth we serve through reunification
with birth parents, guardianship with extended family, adoption into a new forever
family, or life-long connection with caring adults.

In addition to comprehensive case management, we partner with public and private organizations
throughout the city to offer services to our clients in the areas of mental and behavioral health,
physical health, education, substance abuse treatment, intervention for domestic violence issues,
homemaking, mentoring, parenting and life skills training, and child and youth development.

At the end of March 2010, the District’s child welfare population was 4,047 children and youth.
This included 1,953 children1, or 48% percent, who we monitor regularly in their homes and
2,094, or 52% percent, in foster care. We are intensely focused on furthering child welfare
reform and providing what children and youth need most: safety, well being, strong families, and
permanent homes.

1
This number includes 294 children remaining at home while their siblings are served in out-of-home placement.

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Agency Accomplishments: Past Three Years

Over the last three years CFSA, has made steady progress in improving services and
performance. Among highlights are the following.
• Safety Reforms: CFSA’s Child Protective Services Administration is responding
promptly to reports of child abuse and neglect even as the volume of calls to the hotline
has continued at a high level for more than two years. We keep investigations open until
social workers locate families and ensure children are safe. CPS has also maintained the
backlog of investigations (started but not completed within 30 days) in the range of 20 to
60 for 16 months—the lowest level for the longest period in agency history.
• Keeping Families Together: Almost 18 months ago, CFSA moved 70 social workers
and staff to facilities with the community-based, non-profit Healthy Families/Thriving
Communities Collaboratives in neighborhoods throughout the city. CFSA and the
Collaboratives now jointly serve families involved with the child welfare system who
remain at home, doing more to keep these families together and prevent their children
from entering foster care.
• Permanent Homes for More Children/Youth: In CY09, CFSA completed 128
adoptions, exceeding the goal of 125. This was a 25 percent increase in adoptions over
CY08 and a reversal of the trend in declining adoptions. Overall in CY09, CFSA made it
possible for 513 children and youth to leave foster care and return to their parents safely,
enter legal guardianship (often with relatives), or become permanent members of an
adoptive family.
• Improved Outcomes for Older Youth in Foster Care: We have ended the long-
standing and over-used practice of automatically consigning older youth in foster care to
age out of the system with little or no support. Continuing to seek permanent homes or
life-long connections for youth regardless of age while also giving them quality
preparation for adulthood is now our standard practice.

Overall, District child welfare is performing in the top half of systems nationally. The federal
Child and Family Services Review (CFSR) measures outcomes in the 50 states, the District, and
Puerto Rico in the areas of safety, permanence, and well-being and also rates several systemic
factors in each jurisdiction’s child welfare system. The District has participated in the two

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reviews the U.S. Department of Health and Human Services had conducted so far, with the first
round beginning in 2001 and the second starting 2007.

National Child Welfare Outcome Measures

District of Columbia 42 States/Jurisdictions Reviewed to Date
Outcome Ranking Compared Percentage of District Average Percentage of Median Percentage of
to Others Reviewed Sample Cases Sample Cases Sample Cases
to Date Achieving Outcome Achieving Outcome Achieving Outcome
Safety Outcome 1:
Children are, first and foremost,
15 80.80% 72.85% 74.60%
protected from abuse and
neglect.
Safety Outcome 2:
Children are safely maintained
2 81.50% 66.07% 68.20%
in their homes whenever
possible and appropriate.
Permanency Outcome 1:
Children have permanency and 17 41.00% 38.55% 37.50%
stability in their living situations.
Permanency Outcome 2:
The continuity of family
16 71.80% 65.45% 67.50%
relationships and connections is
preserved for children.
Well Being Outcome 1:
Families have enhanced
9 49.20% 43.55% 43.85%
capacity to provide for their
children’s needs.
Well Being Outcome 2:
Children receive appropriate
18 88.00% 87.06% 87.35%
services to meet their
educational needs.
Well Being Outcome 3:
Children receive adequate
3 87.30% 75.37% 75.45%
services to meet their physical
and mental health needs.
Source: DHHS Administration for Children and Families; March 17, 2010

To date, a total of 42 states/jurisdictions have completed the second-round CFSR. In the seven
outcome areas, District rankings range from second to eighteenth out of the 42
states/jurisdictions. The District ranked second in keeping children safe at home whenever
possible and third in providing adequate services to meet health and mental health needs. For the
other five outcome areas, the District ranked in the top half of all 42 jurisdictions reviewed.
What’s more, in each of the seven outcome areas, the percentage of District cases substantially
achieving each outcome was higher than both the average and median percent of cases
substantially achieving each outcome across the 42 states/jurisdictions. Also, out of the 42
states/jurisdictions reviewed to date in the second-round CFSR, the District is the only one

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meeting all seven national system standards. This is a substantial improvement over the first-
round CFSR in 2001, when the District met only four (57%) of these seven systemic standards.

In FY10, we are focusing on following areas.

• Taking Good Care of Foster Children/Youth: We’ve stepped up efforts to ensure

children and youth in foster care are healthy and learning in school. The Healthy
Horizons Assessment Center on site at CFSA (which we opened in place of contracting
out) provides the basic health screening all children and youth receive before entering
foster care. After the basic health screening, children/youth are now scheduled for full
medical and dental exams within 14 days (previously 30 days), and CFSA collects
comprehensive health histories as a basis for informing foster caregivers and improving
child/youth medical records. Social workers are now completing an enhanced educational
assessment every six months about every school-age child and youth involved with the
agency. This keeps school enrollment information up to date and identifies any barriers to
regular attendance or academic achievement that social workers need to resolve.

• Enhance Guidance/Support for Youth in Foster Care: We’re continuing to use youth
input from a survey, interviews, and the Director’s Youth Advisory Board to improve
programs for older youth in foster care and to smooth their transition to independence.
Goals are to give these youth the same quality of preparation for adulthood that those in
intact families receive while simultaneously seeking legal permanence or life-long
connections for them regardless of age. To address a particular request of youth, CFSA is
scheduled to move our Office of Youth Empowerment to a community-based location.

• Expand Oversight of Foster Child/Youth Health: CFSA is expanding the team of

nurses now supporting investigations and foster children and youth with severe medical
issues so that every youngster in care can benefit from skilled oversight of his or her
medical needs and care. Under supervision of CFSA’s on-staff pediatrician, nurses
review health records, advise social workers, and generally ensure foster children/youth
receive quality medical services.

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 • Improve Quality of Placement Services for Children/Youth: CFSA is giving more
children and youth in care a higher quality placement experience by instituting a new
method of purchasing group and foster home services that sets higher standards and
requires measurable outcomes.

FY 2011 Goals/Initiatives

Mayor Fenty’s proposed FY 2011 budget for CFSA reflects the District’s continued commitment
to achieving comprehensive child welfare reform. This proposal provides the level of resources
necessary to sustain performance achievements to date and to support additional progress in
strengthening the local safety net for abused and neglected children and troubled families.

In summary, the FY 2011 budget request is $271,903,083, of which $193,830,000 is local

funding—a point-two decrease from FY 2010. While CFSA gross funds increased slightly, it is
important to note that the proposed budget includes several cost savings initiatives that were
necessary to ensure adequate local funds were available to support core mandates.

I want to put this discussion of CFSA’s FY 2011 proposed budget in context. Nationally, child
welfare is going through a transition where the client population is changing, use of evidence-
based practices is increasing, and funding is dwindling. There’s a strong expectation and need for
child welfare to be more effective and more efficient. In early part of this decade, CFSA was
funded to meet individual caseload standards with a larger client population than we have now.
The number of children we serve has dropped steadily from 7,500 in September 2003, to about
4,000 today—a significant decline of 47 percent.

Use of evidence-based practices keeps children out of system or moves them through more
quickly—exactly what’s supposed to happen. Because resources are increasingly limited, child
welfare agencies are having to rethink approaches to services, become more efficient, and
generally retool in keeping with the new realities. CFSA is no exception.

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Developing CFSA’s FY11 budget required tough decisions. In making the difficult choices, our
objectives were to:
• Preserve direct services to children/families, especially in the areas of our core mission.
• Continue strategies to improve performance.
• Continue strategies to leverage federal claiming.
• Eliminate as many non-essential items from the Agency Management line item as
possible (such as professional memberships).
• Share responsibility for achieving cost savings and efficiencies throughout the system.
• Realign staff to better meet current demands on the child welfare system.

In FY 2011, CFSA continues to leverage federal resource to minimize local costs while
sustaining services. First, CFSA saves $532,680 through federal reimbursements for Medicaid-
eligible services at our on-site Healthy Horizons Assessment Center. Second, we save
$2,334,708 through increased use of Medicaid-certified psychiatric residential treatment
facilities. Finally, establishing Nurse Care Management services to enhance child well being
allows us to transition eligible costs to Medicaid. Shifting costs for hearing examiners to the
federal Title IV-E grant saves $47,356.

Adjusting costs in the Agency Management line item and other programs ensures we can
continue to fulfill critical client service priorities. Savings include:
• $50,570 through elimination of agency membership dues.
• $34,750 by reducing paid advertising for vacant positions.
• A $120,000 reduction in payments to the LaShawn court monitor.
• A $3,500 reduction in employee special events.
• A $13,000 reduction in fleet operation contractual staff.
• $5,830 through aligning costs for Merritt School contractual services.
• $35,545 through elimination of the Public Information printing and materials budget,
paid advertising for contractual procurements, and the Human Resources budget for
employee referral incentives and relocation support.
• $111,000 in savings by eliminating payments to send employees to conferences and
training.

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 • A $4,000 decrease to align the CPS budget for cameras with actual need.

The fiscal reality of CFSA requires setting clear priorities and maintaining some services while
eliminating others. Keep in mind that we must retain core services. Thus, eliminations include
the contract for abscondance services, the Parent Advocate Program grant, the Foster and
Adoptive Parent Association contract, and the Title IV-E student training program for bachelors-
level social workers.

The Clinical Practice program implements $412,726 in cost decreases that will have limited to
no impact on services. We achieved these savings by (1) adjusting costs for Family Team
Meeting hardware purchases and materials that make use of existing agency resources and (2)
aligning costs for contracted staff with projected need.

Finally, a realignment of personnel reduces CFSA staff by 52 full-time equivalents with a cost
reduction of $3,277,947. CFSA will realign core functions to ensure no negative impact on core
services to children and families and maintenance of best-practice caseload standards.

In FY 2011, we fully expect to sustain improvements of the last three years while continuing to
forge ahead.
• Realigning staff to strengthen performance: CFSA will complete a staffing
realignment that will improve the agency’s ability to responds to current demands.
• Shifting to Medicaid Psychiatric Residential Treatment Facilities (PRTFs): CFSA
has historically paid local funds for non-Medicaid residential treatment. In FY11, CFSA
will achieve $2.3 million in savings by moving children and youth to Medicaid facilities.
We’ve started this shift in FY10.
• Best-Practice Caseload Standards: The FY11 budget continues to support best-practice
caseload standards.
• Supporting Permanence: The FY11 budget supports continuation of the innovative
Permanency Opportunities Project (POP), which uses high-impact teams to remove
barriers to permanence and the Post-Permanency Family Resource Center to provide
ongoing support to adoptive parents and guardians.

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Conclusion

The Mayor’s proposed FY 2011 budget demonstrates commitment to a strong safety net for
District children, youth, and families. We appreciate the support and confidence that the
proposed FY 2011 budget represents and respectfully request that you approve it for CFSA.

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