State Innovations in Child Welfare Financing

Submitted to:
U.S. Department of Health and Human Services
Assistant Secretary for Planning and Evaluation

Submitted by:
Westat and Chapin Hall Center for Children

April 2002

This report is available on the Internet at:
http://aspe.hhs.gov/hsp/CW-financing03/

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Contents

Executive Summary

Chapters:

1. Introduction
   • Emergence of Managed Care in Child Welfare
   • Managed Care Assumptions
   • Limitations of Managed Care
   • Methods for the Report
2. Overview of the Initiatives
   • Scope of Initiatives
   • Objectives
   • Structural Models
   • Target Populations
   • Referral Process
   • Level-of-Care Assessments
   • Pre-authorization
   • Contractor Monitoring
   • Evaluations
3. Financial Arrangements of the Initiatives
   • Payment Basis
   • Risk Source
   • Rate Setting
   • Risk and Risk Management
   • Fiscal Incentives, Payment Adequacy, and Contractor’s Financial Status
   • Conclusion
4. What Are the Challenges?
   • Structuring Risks and Rewards
   • Gaining Flexibility
   • Obtaining Data
   • Maintaining Accountability and Effectiveness
   • Changing People and Organizations

Bibliography

Appendix A. Summaries of Fiscal Reform Initiatives

List of Tables:

• 2-1 Summary of State Fiscal Reforms in Child Welfare
• 2-2 Degree of Collaboration
• 3-1 Financial Risk Associated with Payment Methods
• 3-2 Fiscal Features of Initiatives

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Last updated: 07/24/03