A Self-Assessment and Planning Guide: Developing a Comprehensive Financing Plan
by Mary Armstrong, Sheila Pires, Jan McCarthy, Beth Stroul, Ginny Wood, and Karabelle Pizzigati
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 Introduction
The Research and Training Center (RTC) for Children's Mental Health at the University of South Florida is conducting several five-year studies to identify critical implementation factors which support communities and states in their efforts to build effective systems of care to serve the needs of children and adolescents with, or at risk of, serious emotional disturbances and their families. One of these studies, conducted jointly by the RTC, the Human Service Collaborative of Washington, DC, the National Technical Assistance Center for Children's Mental Health at Georgetown University, and Family Support Systems, Inc. examines financing plans, structures, and strategies that communities use to build systems of care.
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Resources:
Mix and Match: Federal Programs to Support Interagency Systems of Care for Children with Mental Health Care Needs
by Chris Koyanagi et al, Judge David L. Bazelon Center For Mental Health Law
Over the past decade, the federal government has provided resources to encourage state to develop interagency systems of care to meet the needs of children with mental or emotional disorders. As states develop such collaborations, they need to draw on various federal funding programs while also using their own resources to support the comprehensive array of services necessary to meet the needs of children with serious mental and emotional disorders. This issue brief helps states and localities use existing federal programs in a coordinated manner to finance the widest possible array of services for children of all ages and income groups.
Public Financing of Home and Community Services for Children and Youth with Serious Emotional Disturbances: Selected State Strategies
by Henry Ireys et al, Mathematica Policy Research, Inc.
The purpose of this report is to present the results of a study of selected public financing mechanisms that states have used to pay for intensive home and community services for children and youth with SED. Although the study covers several key public strategies for funding home and community services for children with SED, it focuses particularly on the Medicaid home and community-based service waiver as a result of recent federal and state interest in this particular financing approach. Better information on strategies for selecting the best set of financing mechanisms may help states design and implement new initiatives for broadening home and community-based alternatives to psychiatric residential treatment and other out-of-home care.
The Cost of Protecting Vulnerable Children V: Understanding State Variation in Child Welfare Financing
by Cynthia Andrews Scarcella et al, The Urban Institute, Child Welfare Research Program
Child welfare agencies provide a safety net for abused and neglected children and children at risk of abuse and neglect. Federal, state, and local government funding supports all services provided by the state child welfare agencies. However, the amount of funding from federal, state, or local sources varies greatly by state and can be affected by both national and state-specific events. The findings document the amount states spent on child welfare activities in SFY 2004, the funding sources they used, how child welfare spending changed since SFY 2002, and why we see such state variation in child welfare spending.
Spending Smarter: A Funding Guide for Policymakers and Advocates to Promote Social and Emotional Health and School Readiness
by Kay Johnson and Jane Knitzer, Columbia University, Mailman School of Public Health, National Center for Children in Poverty
Spending Smarter is designed to help state legislators, agency officials, families, and other advocates think strategically and take steps to meet the challenge of utilizing existing funding streams to promote the social and emotional health and school readiness of young children. The framework and content of Spending Smarter is designed to help state and local leaders maximize the impact of federal funding and feed confident that they are using existing resources in the most effective way.
The Changing Landscape of Federal Child Welfare Financing: A Primer for Policymakers
by Steve Christian, National Conference of State Legislatures
Although states have the primary responsibility for protecting children from abuse and neglect, they rely heavily on federal funding to fulfill this responsibility. Recent federal legislation will have the effect of shifting more of the cost of child welfare to the states and imposing additional limits on state flexibility to spend federal funds. This paper examines some of the changes in federal policy and their likely effect on states. It also briefly examines what are considered to be the major flaws in the current structure of federal child welfare financing and proposals for reform.
Additional Resources:
Strengthening Families in America's Cities: Municipal Finance for Child and Family Services
by Cheryl Katz et al, National League of Cities
Thinking Broadly: Financing Strategies for Comprehensive Child and Family Initiatives
by Cheryl Hayes
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The purposes of the study are to:
- Develop a better understanding of what are the critical financing structures and strategies to support systems of care for children and adolescents with behavioral health disorders and their families;
- Examine how these financing components operate separately and collectively; and
- Promote policy change through dissemination of study findings and technical assistance to states and local policy makers and their partners.
During Year One of the study, the study team convened a panel of financing experts, including family members, state and county administrators, representatives from tribal organizations, providers, and national financing consultants to develop a list of critical financing strategies and study questions that form the basis for interviews to be conducted in the case study sites. These critical financing strategies were used to create this Self-Assessment and Planning Guide.
How to use the Self-Assessment and Planning Guide
The Self-Assessment and Planning Guide (Guide) addresses seven important areas to assist systems/sites to develop comprehensive and strategic financing plans for building effective systems of care:
- Identification of current spending and utilization patterns across agencies
- Realignment of funding streams and structures
- Financing of appropriate services and supports
- Financing to support family and youth partnerships
- Financing to improve cultural/linguistic competence and reduce disproportionality in case
- Financing to improve the workforce and provider network for behavioral health services for children and families
- Financing for accountability
For each of these seven areas, the Guide presents both outcomes that can be achieved and financing strategies that may help to achieve them. Systems/sites can use this Guide to assess their current financing structures and strategies and to prioritize how they want to move forward in developing a strategic financing plan. While all seven areas are important components of a comprehensive financing plan, it is not necessary to move sequentially through the seven areas. Your system/site already may address one or more of these areas. The Guide is intended to help you focus on those areas that your system/site needs to address.
A checklist format is used for the outcomes and the strategies in each area. This will help your system/site conduct a self-assessment and identify which outcomes and strategies to pursue and explore. The questions in the box below may help you to decide where to begin the self-assessment process.
When you have reviewed all areas relevant to your system/site and have identified which outcomes and strategies to pursue, you should be in a position to begin developing a strategic financing plan to fund and support an effective system of care.
Deciding Where to Begin
- What do key stakeholders feel should be done first?
- Which financing strategies and structures to support effective systems of care are in place now in your system/site? Which ones need to be developed?
- Which financing strategies and/or structures may be difficult to accomplish but could have a major impact, i.e., which ones would need to accomplished with a long-range strategy?
- What strategies may be relatively easy to achieve and viewed as short-term wins, i.e., which ones could be accomplished through immediate action?
- Which areas of the Guide might be most useful now?
We hope that planners, policy makers, advocates, family representatives, researchers, and others engaged in building systems of care for children and families will find the Guide to be a useful roadmap.
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