Plea for help

Dear Members of the Kentucky Legislature,

Private providers who contract with the Department of Community Based Services cannot wait until July of 2008 to get an increase in reimbursement rates.  Here is a sample of why.

Susan is fifteen before she reports that her stepfather has been sexually abusing her for years.  She gathers the courage to report him only to find her mother sides with her husband even though she knows Susan’s accusations are true.  Child Protective Services remove Susan from the home while step-dad remains there with mom.  Susan feels angry, confused, betrayed and dirty.  The court awards The Department of Community Based Services temporary custody of Susan.  State social workers must find a place for her to stay, receive treatment and begin putting her damaged life together.  Where will DCBS place her?  They (DCBS) operate no residential facilities and Susan’s behaviors and needs are beyond the scope of a foster-family.  DCBS, as they have since the 1970’s, turn to the private provider community for a placement but find every bed for girls with Susan’s needs filled across Kentucky.  A placement must be found for Susan because she is now legally the responsibility of the Commonwealth.  They MUST place her somewhere.  Since there is no available bed for Susan in Kentucky, DCBS must send her out-of-state or place her in a very restrictive and expensive psych hospital bed.  Susan is victimized once again.

Why is there no bed for Susan?  Here is why.

• Because the private sector that provides the only resource of residential treatment in Kentucky for children like Susan have been under-funded for years.  Consequently, financial pressures force them to close their doors. (125 beds closed in January 2007)

• The current reimbursement rates for private providers were established by 1999 allowable cost reports and have not been adjusted since. (One rate was increased by only a few dollars once).

• Since 2000, the standards, accreditation requirements and regulations to care for state-agency-children have increased but the rates have remained the same.

• Since 2000, staffing ratios, all insurances, utilities, salaries, benefits, etc. have all increased dramatically.  Nevertheless, the daily per-diems paid to private providers remain the same.

• Since 2000, the numbers of children coming into the child welfare system have increased along with the numbers of them requiring extensive treatment due to substantiated abuse and neglect but the rates remain the same. ( 5,000 five years ago to over 7,300 today)

• Last fiscal year the costs of residential care for state-agency-children exceeded reimbursement by $12M.  Expenses increase annually but the rates have remained the same!

Why have private providers continued serving?  Because, for most of them serving hurting children is their mission.  They will care for the kids until their last dollar is gone.  Some providers have already spent their last dollar and closed their doors.

Private providers have reduced costs, increased care and collaborated with the Cabinet for Health and Family Services to care for Kentucky’s at-risk, vulnerable and suffering children. Financial and regulatory issues have stretched many to the point of collapse.  More will no doubt be forced to cease serving.

We and other providers have been waiting, struggling and serving since 2000 without a rate increase.  I do not think many providers or the children they serve can wait until July of 2008 for relief.  The collapse of this vital child welfare infrastructure will be catastrophic for Kentucky.

So, what will we tell Susan if she has to go out-of-state after removal from her home, school, friends and family?  Sorry Susan, it was not a budget year.

The Federal Government will match the $7.5M requested for the DCBS “alternatives for children” increase with another $7.5M in federal monies.

Please!!  Fund the request for DCBS’ “alternatives for children” that was originally in HB 327.  The voiceless, at-risk children of Kentucky and those of us who care for them daily desperately need your immediate help.  Do not let what happened to “Susan” actually victimize another Kentucky child.