Chair, Health and Human Services Committee
Room 1402, State Capitol
Lincoln, NE 68509
Chairwoman Campbell and members of the Health and Human Services Committee,
On behalf of the Nebraska Appleseed Center for Law in the Public Interest, I am here to testify in support of LB 821.
We support LB 821 because it seeks to address key ongoing systemic concerns in the child welfare system, including poor coordination, system fragmentation, service gaps and cost-shifting. In addition, LB 821 would put into place important components of child welfare reform that have been largely absent from the Families Matter initiative, including the involvement of all three branches of government, the creation of a strategic plan, and stakeholder input. We believe these deficiencies have contributed to the problems seen over the course of the past two and a half years of the privatization and reform effort.
Specifically, we support the provisions of LB 821 that would establish a Children’s Commission to develop a strategic plan and support that this process would include consideration of issues including the role of lead agencies, how to eliminate financial incentives that may conflict with the best interests of children, and support of evidence-based programs and early intervention. Finally, we believe it is important, as the bill requires, that the Commission would include representatives from all three branches of government and that it also provides a means for other stakeholders, including parents, youth, and foster care providers, to apply for membership.
We also strongly support the establishment of local community networks to identify local needs and facilitate collaboration to strengthen the continuum of services and to provide resources outside of the child protection system. As this Committee has rightly pointed out in the past, although privatization is remaining only in the Eastern and Southeastern Service Areas currently, child welfare reform must be statewide, and, unfortunately, the service array in rural areas have been particularly harmed by the privatization and unpaid outstanding debt. Community networks could help the system rebuild on a local and statewide level.
Finally, Appleseed has repeatedly called for an independent statewide evaluation of the child welfare system and has long supported increased availability and transparency of HHS data that can be used to inform policy decisions and, most importantly, to insure the system is truly service children and families. We therefore support these aspects of LB 821.
With regard to legislation to create a new Department of Children’s Services, we recognize the need for a system-of-care approach, including inter-agency collaboration, cultural competence, community based services and accountability, and strongly support these and other goals identified in LB 821. We are also supportive of the proposed Medicaid cross-systems analysis.
However, we do have some questions about separating “children’s services” from “family services,” because of the significant number of children in out-of-home care due to poverty or neglect and because services that help families and prevent poverty also help children. Therefore, we want to make sure, as this process moves forward, that critical programs and services that serve families as a whole are considered at every step. We would ask the committee and/or commission to consider how the proposed Department of Children Services and the existing Department of Health and Human Services will function together to create success for children and families and how cross-cutting programs such as Aid to Dependent Children might work effectively. We also have questions about how potential disagreements between the new and existing departments would be addressed, particularly with regard to the authority of the deputy director to make decisions regarding children’s Medicaid.
Finally, while LB 821 would create an important structure and sets forth important goals for improving the child welfare system and services for children in the state, we agree with the Committee’s LR 37 recommendations that this must be part of a larger package of reform. We also believe a critical piece to addressing some of the issues identified in LB 821, such as cost-shifting and service deficiencies, must be to clarify the medical necessity definition for children and to prohibit overly restrictive Medicaid policies that exclude certain children from receiving services under Medicaid. We therefore believe that LB 1063, introduced by Senator Cook, is a vital component.
We look forward to working with the Committee on these proposals. And we thank the Committee again for your leadership in seeking to find solutions to address challenges in Nebraska’s child welfare system.
Sincerely,
Sarah Helvey
Staff Attorney/Director
Child Welfare System Accountability Program
Nebraska Appleseed[/DDET]