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Florida

Demonstration Type:	Flexible Funding1
Approval Date:	March 31, 2006
Implementation Date:	October 1, 2006
Expected Completion Date:	September 30, 2011
Interim Evaluation Report Expected:	May 31, 2009
Final Evaluation Report Expected:	March 31, 2012

Target Population

Florida's flexible funding demonstration targets (1) title IV-E-eligible and non-IV-E-eligible children ages 0–18 who are currently receiving in-home child welfare services or who are in out-of-home placement at the start of project implementation, and (2) all families entering the State's child welfare system with a report of alleged child maltreatment.

Jurisdiction

Florida is implementing its flexible funding waiver demonstration statewide.

Intervention

Florida's flexible funding demonstration includes the following components:

1. Capped Allocation of Title IV-E Funds and Contracts with Community-Based Lead Agencies: Florida is receiving a capped allocation of title IV-E funds to support community-based services and activities that promote child safety, prevent out-of-home placement, and expedite permanency. The State distributes these funds either through payment for activities performed directly by the State or through contracts with local governmental entities or private and non-profit Community-Based Care (CBC) Lead Agencies. The CBC Lead Agencies are responsible for providing and coordinating services, programs, and supports funded using waiver dollars in their respective service areas in the State.
2. Improved Array of Community-Based Services: The State and its partnering Lead Agencies are using title IV-E funds to expand the array of community-based services and programs available to eligible children and families. Examples of services and programs that may be expanded under the demonstration include:
   • Intensive early intervention services;
   • One-time payments for goods or services that reduce short-term family stressors and help divert children from out-of-home placement (e.g., payments for housing, child care);
   • Enhanced training for child welfare staff and supervisors in service delivery, case management, and supervisory practices;
   • Improved needs assessment practices that take into account the unique circumstances and characteristics of children and families; and
   • Long-term supports for families to prevent placement recidivism.

In addition, existing community-based programs in Florida may be expanded under the demonstration, including Healthy Families Florida, a community-based voluntary home visiting program.

Evaluation Design

Florida's evaluation includes process and outcome components, as well as a cost analysis. The State is utilizing a time series design for the evaluation of its demonstration to analyze historical changes in child welfare outcomes. Longitudinal changes in child welfare outcomes are analyzed by measuring the progress of successive "cohorts" of children entering the State's child welfare system toward achievement of the demonstration's primary goals. Evaluation cohorts are defined and identified using data available in the State's child welfare information system. To measure the historical progress of each evaluation cohort, the State established a baseline for each outcome measure prior to implementation of the demonstration and is comparing this baseline to subsequent achievement benchmarks at selected time intervals.

Process Evaluation

Florida's evaluation includes interim and final process analyses that describe how community-based lead agencies implement policies to improve the array of services to promote child safety and permanency. Furthermore, the evaluation identifies new prevention and diversion services and examines how the availability of these services has changed since waiver implementation. More specifically, the process evaluation compares the availability, accessibility, intensity, and appropriateness of community-based services prior to and following implementation of the demonstration. Data collection methods utilized by the State for the process evaluation include focus groups, surveys, and interviews involving lead agency directors, court personnel, caregivers, and child welfare staff and administrators.

Outcome Evaluation

For each successive cohort of children who are currently in or who enter the child welfare system, the State's outcome evaluation is tracking longitudinal changes in key safety, permanency, and well-being outcomes. Major outcome measures of interest include the following:

• Number and proportion of children exiting out-of-home care within 12 months of removal from the home;
• Number and proportion of children remaining in out-of-home care 12 months after removal from the home;
• Mean/median length of stay in out-of-home care; and
• Number and proportion of children adopted within 24 months of out-of-home placement.

Previously, all data used in the outcome evaluation analyses were abstracted from HomeSafenet (HSn), the State's child welfare information system. However, Florida has transitioned to a new information system, Florida's Safe Families Network (FSFN), and all subsequent data files will be extracted from this system. In addition, comparison data from national databases, such as The National Survey of Child and Adolescent Well-Being, will be incorporated into the outcomes analysis.

Cost Study

Florida's cost study examines the costs of key elements of waiver-funded services received by children and families and compares these costs with those of traditional services and foster care placements prior to the start of the demonstration. Specifically, the State's evaluation team established and has begun collecting baseline data on three key research questions: (1) the extent to which CBCs have maximized the use of their IV-E budgets; (2) the ratio of CBCs' spending on foster care maintenance to spending for prevention and family preservation; and (3) the extent to which CBCs are able to use their TANF and State budget allocations. Where feasible, the State is conducting a cost-effectiveness analysis by examining the relationship between the demonstration's costs and outcomes.

Evaluation Findings

Process Evaluation

A Child Welfare Practice Analysis survey was distributed by e-mail in August 2007 to 20 CBC lead agencies to obtain information concerning changes in child welfare programs, services, system strategies, staff training, and community and consumer involvement in program planning. Nineteen of the twenty lead agencies responded, of which 15 reported either an expansion of existing services and strategies or the development of new services and strategies that included the following:

• A variety of prevention strategies and innovative practices have been implemented including, the development or expansion of Family Team Conferencing as a placement prevention strategy;
• Collaboration with the Children's Services Council in their area to create enhanced partnerships with existing community providers; and
• Formal, ongoing processes for bringing community stakeholders together to discuss system of care assessment and planning.
• Enhanced Staff Training

Outcome Evaluation

The most recent collection of cohort data was completed by June 30, 2007. As of March 31, 2008, the statewide out-of-home care population was 24,118 (a 19 percent decline from September 30, 2006). Furthermore, according to the September 2007 semi-annual report, all permanency outcomes significantly improved while stable or improved longitudinal trends in several safety outcomes were found. In addition, the State's evaluation team examined several State Fiscal Year (SFY) 05-06 cohorts to assess progress on several key child safety and permanency indicators:

• The proportion of children entering out-of-home care statewide was 23.3 percent. While the Department of Children and Families (DCF) has not established a target for this measure and there is no national standard, there was wide variation in CBC lead agencies' performance on this indicator. Specifically, the proportion of children entering out-of-home care within 12 months ranged from 14.3 percent in one CBC lead agency to 39.3 percent in another CBC lead agency. The evaluation team notes that State and lead agency performance on this indicator will be evaluated over time to assess the success of prevention and diversion services related to the waiver.
• Statewide, 48.2 percent of children who entered out-home care in SFY05-06 exited care within 12 months for reasons of either reunification or placement with relatives. The range across CBC lead agencies spanned from 30.8 percent to 62.7 percent. The State goal set by DCF for the proportion of children exiting within 12 months for reason of reunification is 76 percent, with none of the CBC lead agencies or the State as a whole achieving this goal.
• The proportion of children discharged in SFY05-06 to their original caregivers or with relatives that re-entered out-of-home care within 12 months was 9.5 percent statewide. CBC lead agencies' performance ranged from 6.2 percent to 14.1 percent on this indicator, with 12 of 19 (63 percent) lead agencies not meeting the State standard of 9 percent or less.
• Across all lead agencies, an average of 7.5 percent of children in the SFY05-06 cohort experienced maltreatment while receiving services. Analysis of variance indicated that children served only during SFY04-05 were significantly more likely to experience maltreatment during services than children served only in SFY05-06. In addition, children who exited out-of-home care during SFY05-06 were 2 percent less likely to experience repeat maltreatment within 6 months of discharge than children who exited out-of-home care in SFY04-05, a statistically significant difference.

Limitations to the above analysis include the following: (1) no well-being measures were analyzed, (2) data are based on self reports from CBC lead agencies, and (3) no comparison group was available for analysis. Additional findings of the flexible funding waiver with respect to key child welfare outcomes will become clearer as implementation continues.

Cost Analysis Findings

Lead agencies and DCF have reported that increased flexibility in the use of title IV-E funds has improved their ability to use available resources more effectively. For SFY 06-07, all 22 CBC lead agencies spent all of their available title IV-E foster care funds, for a total of $179.6 million. This differs from SFY 05-06, during which lead agencies underspent title IV-E funds by $1.3 million. Moreover, in comparing SFY06-07 data to SFY05-06 data, the proportion of spending on prevention/family preservation/in-home services increased from 3.2 percent to 5.7 percent statewide, with a modest increase in the proportion of spending on licensed out-of-home care and a notable decrease in the proportion of spending on dependency case management.

Web Links

Semi-annual reports for Florida's flexible funding demonstration for 2006–2007 are available at the following Web site: http://cfs.fmhi.usf.edu/pub-list.cfm.

¹ Based on information submitted by the State as of April 2008. Back

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