Consistency Across Foster Care Service Providers (Limited Scope)

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Audit Team

Supervisor

Meghan Flanders

Manager

Chris Clarke

Published January, 2020

Introduction

Representative Leo Delperdang requested this limited-scope audit. It was authorized by the Legislative Post Audit Committee at its July 29, 2019 meeting.

Objectives, Scope, & Methodology

Our audit objective was to answer the following question:

What are stakeholder’s opinions on whether Department for Children and Families’ processes to ensure service consistency and family transitions from one provider to another are adequate?

We interviewed officials at the Department for Children and Families (DCF). We also reviewed Kansas statutes and regulations, DCF contracts with child placing agencies, and DCF licensing documents. We focused our work on services that child placing agencies should be providing to foster families. We did not cover all the other areas of services that child placing agencies provide or the services that foster care case management contractors provide.

We surveyed 182 foster families who have used at least two child placing agencies in the last two years about two issues: the consistency in services between child placing agencies and whether it is easy to transition between child placing agencies.

More specific details about the scope of our work and the methods we used are included throughout the report as appropriate.

Important Disclosures

We conducted this performance audit in accordance with generally accepted government auditing standards. Those standards require that we plan and perform the audit to obtain sufficient, appropriate evidence to provide a reasonable basis for our findings and conclusions based on our audit objectives. Overall, we believe the evidence obtained provides a reasonable basis for our findings and conclusions based on those audit objectives. Audit standards require us to report confidential or sensitive information we have omitted. In this audit, we omitted specific survey responses because audit surveys are confidential pursuant to KSA 46-1129.

Most foster families we surveyed reported inconsistencies in some child placing agency services, but that the process to switch agencies was not difficult.

The Department for Children and Families (DCF) contracts with private organizations to provide foster care services.

DCF currently contracts with four organizations to provide foster care case management work. Those organizations are KVC Kansas, St. Francis Ministries, Cornerstones of Care, and TFI Family Services. A case management contractor is assigned to children entering the foster care system. The contractor handles their case plan and coordinates the services they should receive.

DCF also currently contracts with about 30 child placing agencies. Before October 2019, the case management contractors subcontracted with the child placing agencies. The child placing agencies handle things like recruiting foster families, preparing them for licensing, and supporting them when they take in foster children. Child placing agencies are paid for each day that a foster child is placed in one of the homes they sponsor.

Foster families must be licensed and sponsored by a child placing agency. Foster families can choose which child placing agency they want to sponsor them. A child placing agency can choose to not sponsor a family. DCF does not interfere with these decisions.

Child Placing Agency Service Consistency

DCF has policies and procedures to help ensure a minimum standard of service but child placing agencies can offer more or better services if they choose.

We examined child placing agencies and the services they provide to foster families. Because of the limited scope of the audit, we did not do any test work to determine if DCF policies and procedures were effective in actual practice.

DCF sets minimum service requirements in multiple areas including licenses, contracts, and complaints. For example, child placing agencies must be licensed and follow the Kansas regulations. Also, DCF now requires child placing agencies to sign contracts directly with DCF which contain more specific standards than the regulations. Finally, DCF investigates complaints received about child placing agencies.

DCF also has a has an internal committee to approve audits of various DCF and contractor activities. There are not currently any audits scheduled to look at the services child placing agencies provide foster families, but they have been done in the past. A 2018 DCF audit found problems with child placing agency completing timely monthly visits. Officials told us the audited child placing agencies did not respond to those audits or file corrective action plans. Because of that, officials told us they are currently working on their audit process and plan to update their audit follow-up procedures.

These policies and processes set a minimum standard of service for child placing agencies. Nothing prevents a child placing agency from offering more or better services. This could lead to an inconsistency in services from child placing agencies.

Most foster families responding to our survey reported inconsistencies in some services provided by different child placing agencies, including how well the agencies helped them navigate the foster care system and the quality of interactions with staff.

At our request, DCF identified 187 foster families who have used at least two different child placing agencies in the last two years. We were not able to conduct data reliability on the contact list, so we have relied on DCF for its accuracy. We sent a brief online survey to 182 of the families to gather their opinions on their experiences with two or more child placing agencies. Five email addresses for foster families were rejected by the survey software because they were either invalid or had previously unsubscribed from the software’s emails.

We received 75 responses for a response rate of 41%. We report only on the responses we received. The results cannot be projected.

To get their opinion on the consistency in services between the child placing agencies, we asked them whether there was a significant difference in:
- how well the different child placing agencies helped them navigate the foster care system
- how quickly the different child placing agency staff responded to their requests for help and services
- the quality of interactions with staff at the different child placing agencies
- the quality of training provided by the different child placing agencies

As shown in Figure 1, for the first three questions, about 75% of responding foster families said that one child placing agency was significantly better than the other. For the last question about training, about 56% of responding foster families said training at one agency was significantly better than the other.

Most of the child placing agencies we talked to also said there are differences in the services provided by the different agencies.

We interviewed four child placing agencies, one of which was also a case management contractor. We chose child placing agencies that we knew had foster families who had transferred to or from their agency. Location and service area was also a factor because we wanted to cover a large portion of Kansas.

Three of the placing agencies said there are services they offer that others might not. Because of the limited scope of the audit, we are reporting only on the agency’s opinions and did not do any test work to verify if these services are in fact different.
- One agency said they are large and have private donors. This means they might be able to offer services and hold events that smaller agencies cannot.
- One agency said their organization focuses on services for children with special needs. If foster families are sponsored through them, they would have easier access to the additional training and services offered for children with special needs.

Ease of Changing Child Placing Agency Sponsorship

DCF does not have any specific policies related to foster families who want to change child placing agency sponsorship.

Because foster families must be sponsored by a child placing agency, DCF tracks when a foster family switches child placing agencies. They require foster families to fill out a form to notify them of any changes in sponsorship.

DCF officials said they also provide information to any foster family who asks about the process to change child placing agencies. Officials said they do not recommend specific child placing agencies. Also, they do not interfere with the decisions to change child placing agencies. Officials did not identify any other specific policies or processes about transferring agencies.

The four child placing agencies we talked to all described a similar process for foster care families to switch agencies.

Generally, if a family wants to switch child placing agencies, they contact the agency they wish to transfer to. The new agency will meet with them to make sure it is a good fit. The new agency will also ask that they sign a release so the family’s file can be transferred from their current agency to the new agency. The new child placing agency prefers to review the family’s file before accepting them.

If the new child placing agency accepts the family, the family completes the necessary paperwork. In addition to paperwork for the new agency, the family must also file a form with DCF to notify them of the change in sponsorship.

Each child placing agency may have their own internal rules related to transfers. There are not any specific rules or regulations on how the agencies are to handle the transfer process, other than filing the required forms with DCF.

Only 23% of foster families responding to our survey said the process to transfer to a new child placing agency was difficult but most also said it could be improved.

We asked foster families who had switched child placing agencies how they would rate the process: easy, neither easy nor difficult, or difficult. As Figure 2 shows, about 23% of foster families said the process to switch was difficult. About 39% said the process was easy and about 39% said the process was neither easy nor difficult

We also asked the foster families if they thought the process to switch from one agency to another could be improved. About 66% said it could be improved. Most of those people provided specific suggestions related to paperwork and communication. Here are some of the suggestions:
- “When we switched agencies, we had to start all over on all the paperwork. It would streamline the process if documents such as pet vaccinations, background checks, and most of the application could be shared between agencies. We spent weeks duplicating forms we had already filled out with the previous agency.”
- “A clear explanation of how the process works and contact directly with DCF” would help.

Three child placing agencies also told us a better way to transfer paperwork, clear communication between agencies, or clear guidance from DCF might help the transfer process.

A few foster families and an official at child placing agency mentioned concerns about child placing agencies retaliating against foster families who transfer away from them.

Five foster families responding to our survey mentioned concerns about retaliation or other negative actions related to a transfer request. For example: “
- “There was fear one agency would retaliate.”
- “…then when you request a transfer to a different agency they falsified information to make the foster parent look bad…”

One child placing agency said they have heard from foster families that other child placing agencies make it difficult for families to switch by causing delays, providing false information, or threatening retaliation.

Recommendations

We did not make any recommendations for this audit.

Potential Issues for Further Consideration

We identified an issue that might be worth evaluating in more detail, but because of the limited scope of the audit, we did not have time to fully explore it. Although we had unresolved questions about the following issue, more audit work would be needed to determine whether they represent an actual problem or not.

Because of the limited scope of this audit we were not able to test whether DCF’s policies and procedures were effective in practice. Certain policies and procedures to help ensure consistency in services may be lacking effective enforcement mechanisms. We noted in the report that a previous internal DCF audit of child placing agency services found deficiencies, but no official responses or corrective action plans were filed by the agencies. A DCF official said they are currently working on the audit processes and procedures. We were not able to test if the internal audits, or any of the other processes and procedures discussed in the report, were effective in ensuring consistency across child placing agencies.

Agency Response

On January 16, 2020 we provided the draft audit report to the Department of Children and Families. Agency officials generally agreed with our findings and conclusions. The response is included in this report.