We support LB 1160 because it would establish much needed oversight of what is really happening to children and families in the child welfare system. We fully support that the data collected as part of LB 1160 is targeted to provide accountability in individual cases but also seeks to use the information for ongoing systemic monitoring and improvement. Importantly, LB 1160 would also streamline data systems so that information from all entities responsible for serving children is coordinated.[DDET LB 1160 Testimony]
Senator Kathy Campbell
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 1160.
We support LB 1160 because it would establish much needed oversight of what is really happening to children and families in the system. We fully support
that the data collected as part of LB 1160 is targeted to provide accountability in
individual cases but also seeks to use the information for ongoing systemic
monitoring and improvement. Importantly, LB 1160 would also streamline data systems so that information from all entities responsible for serving children is coordinated.
The LR 37 process has been exceptionally beneficial to investigating the reform, identifying core problems and needs in the system, and developing comprehensive solutions. In our view, LB 1160 would extend this process and institute ongoing evaluation, transparency, accountability and oversight. Instituting evaluation, transparency, accountability and oversight has been a key message of Appleseed and other advocates and has been rightfully identified by this committee as an existing systemic deficiency. We therefore support LB 1160 as a means of addressing these vital issues.
Specifically, we believe the annual report required by LB 1160 addresses an appropriately broad range of key issues. One suggestion we would offer would be to collect additional information with regard to non-court involved cases, to include more specific information about what services are actually provided and the funding source.
Appleseed and other advocates have also long called for an independent evaluation of the system by a national expert. Therefore, we support that LB 1160 provides for such an evaluation that would assess the impact of privatization, including outcomes and costs, as well as the status of children placed in residential treatment settings. With regard to the focus of the evaluation, we would offer two comments. First, we want to reiterate that we strongly support LB 961. Therefore, to the extent that LB 1160 contemplates lead agencies’ role in case management, we believe case management should be returned to the state and the evaluation should, in that circumstance, focus on the service coordination and other roles played by lead agencies.
Second, we believe the evaluation’s focus on residential treatment could be
broader, to include an evaluation of cost shifting that is occurring at all levels of care. In addition, in our experience, it would be important to examine not only the percentage of children denied the level of care originally requested, but also the percentage of children denied re-authorization requests or subsequent reviews of initial authorizations, as denials of services often occur at later points in time. We would offer the same suggestion with regard to the annual report by the Department in Section 6, subsections (c) and (d). Finally, while we strongly support the data collection, we want to be clear that other solutions and changes in the Medicaid program are imperative to help address the deficiencies in children’s behavior health today and that there is no time to waste on that front. LB 1063, which is scheduled for a hearing before this Committee tomorrow, does that and we anticipate providing strong support for that measure as well.
In addition, we support that LB 1160 provides for annual surveys of children, parents, foster parents, judges, attorneys, and service providers. We believe valuable information was collected from the surveys as part of LR 37 and that there should be an ongoing mechanism for systematically collecting data and input from these stakeholders – not just on a qualitative basis from representative stakeholders as LB 821 and other bills recognize, but also providing opportunities for all involved in the system to provide input and to analyze that data in the aggregate as this provision would establish.
Time and time again, from the State Auditor’s report to the individual experiences of families in the system, it is clear that we must create ongoing mechanisms for evaluation, transparency, accountability and oversight. Therefore, we thank the Committee for your hard work on these critical issues and respectfully request that you vote to advance LB 1160 out of committee.
Child Welfare System Accountability Program[/DDET]