Saturday, November 19, 2011

Economic Solutions in the Child Welfare Sector

So today's blog post is short a multiple choice test. Some background information you will need to take this test:

Road to Independence Funding: RTI, in general, provides funds for young adults who have aged out of foster care and who meet requirements of "progress" academically. The funds are intended to help youths complete their education and/or training, providing them with a cushion to allow them to make a start in life as they earn their education and hopefully have food, shelter and clothing while doing so. Monthly stipend for qualified youths in Florida: $892. 

Bus fare on Miami MetroBus: $2

Transfer on Miami MetroBus if you do not have an Easy card: $2 for every bus you ride when you pay cash.

Number of School Days in an Average Week: 5

Number of Buses to School: 10 if you travel without transfers

Number of Buses to School If You Are Really Unlucky: 20+ with transfers

Weekly Fare with Easy Card: $20 weekly

Weekly Fare if You Pay Cash: $20 without transfers and $40 or more with transfers.

Just for kicks:

Median Rent in Miami-Dade County (with Lease): $890, lower quartile: $676

The Baker Act: A Florida law that provides for a 72 hour hold for a person who you believe to be a risk to themselves or others, due to a mental health crisis.

Agency for Persons with Disabilities: APD, an organization undergoing severe budget cuts under Governor Rick Scott's inimitable (thank the quantum field) governing style.

Agency for Health Care Administration: The people who administer Medicaid in Florida.

Certified Behavioral Analyst: A person who helps develop behavioral strategies for children or adults who have significant behavioral issues due to their mental health status or developmental disabilities.

Total Annual Cost for Level 1 (supervision) and Level 3 (biweekly documentation of plan and implementation reviews) CBA services for a 13 year old child: $4300

Locked Mental Health Unit Crisis Hospitalization, 10 days: estimated cost on state Medicaid dollars, perhaps $2500- $5000 daily? Estimates vary based on the facility surveyed. (please note that it is evidently impossible in most facilities for any patient hospitalized on a 72 hour hold toward the end of a week to be discharged on a Saturday or Sunday. Of course, they get out on Monday!)

And now for our quiz! Excitement!!!

Question #1:

If you wanted to cut costs in your Independent Living Program for your aged out foster care youth, you would:

A. Stop providing bus cards for your aged out youth in good standing in your RTI program.

B. Make youths in good RTI program standing apply for bus cards, and have their applications approved or denied, thereby creating a situation where it is a burden for youths at far ends of your very large county to come in and apply, go home, wait for a decision and then if they are lucky, come back and get their bus card. (Oh, by the way, that would be using the public transportation that they likely don't have a bus card for... Hmmmm.) Hey, maybe they won't bother to apply. That's $$$ saved!

C. A and B.

D. Realize that if students can't afford to get to their classes on public transportation that they may then fail in school and that you can therefore drop them from your RTI program! Yay! You saved money!

E. All of the above.

Question #2:

If you wanted to save money on APD service provision for Behavioral Focus Clients/Consumers, you would lower them off the expensive Behavioral tier of service and:

A. Eliminate their behavior therapy services because they really didn't need them anyway because, hey, they're not on that service tier.

B. Make the staff in the consumer's group home responsible for their own behavioral strategies in working with this client. (Hope they don't get too frustrated or anything...)

C. Provide fewer dollars for the group home owner to compensate their staff for handling behaviorally challenging consumers in their group home. (Hey, those 15% cuts to group homeowners were necessary!)

D. Decide that spending $4300 a year on behavior services is not worthy preventive care. Preventing $50,000+ in 4.5 months on 10 days of crisis hospitalization for 13 year old with lifelong, deeply entrenched behavioral problems, and who has now been Baker Acted twice in the 4.5 months since you eliminated her behavioral therapeutic service is way stupid and not your problem. Besides, AHCA is picking up her hospital stays and that's not money coming directly out of your APD coffers! Yay! You saved money!

E. All of the above.

I'll leave it to you to figure out the right answers. M'kay?

© Bright Nepenthe, 2011

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