Budget! Contact House Members

Social Services Consortium Members,

 

The House is in the fast track to developing a budget and we could see one as early as Tuesday (May 17) of next week. Please contact your Representatives today, this weekend, or by Monday to let them know the needs we have for the budget. I've provided 4 major issues to discuss along with talking points for each below:

 

1. Don't keep the Senate's cuts to Medicaid.

• This cut hits only the poorest of poor : Currently, elderly, blind, or disabled North Carolinians can get Medicaid only if their income is less than $9,570 a year (100% Federal Poverty Level). The Senate changes this limit so only people making less than $6,948 a year (73% Federal Poverty Level) can get Medicaid.
• The most frail and at-risk people Medicaid covers : These are people in poverty, many unable to leave home, and many may need institutionalization in a nursing home. Just because we cut them off of health coverage doesn't mean their medical needs go away. They'll delay care and maybe die earlier or show up in a county hospital emergency room or clinic with even more serious medical problems.
• 57,000 will lose in-home personal and nursing care, dental services and more: Elderly, blind, or disabled residents in poverty who are currently on Medicare and Medicaid will still have most hospital, doctor, and (as of 2006) prescription drug services covered even when they lose Medicaid. However, they will lose all other services not covered by Medicare that were covered by Medicaid. As anyone who is on Medicare knows, there are huge gaps in the health services provided by Medicare especially if you have a serious disability. For example, in-home nursing care keeps people who are very sick at home with their families and out of expensive institutions like nursing homes.
• 8,000 will lose all health care: Blind or disabled residents who are on Medicaid but have not yet gotten on Medicare will be the worst hit. While many folks will have applied for Social Security disability and Medicare, the minimum waiting time for Medicare health coverage is almost two and a half years (29 months). This assumes that the person with the disability has immediately applied for Social Security disability and Medicare, gotten a very quick hearing from the federal government and the federal government has almost immediately made a decision. The less-than-speedy reality of the federal government's action in these cases means that almost everyone will wait longer than the current two and a half year minimum. In North Carolina we don't wait years for federal government action before we take care of our poorest and most vulnerable residents.   We make a commitment to all our blind and disabled residents living in poverty that they can at least get Medicaid health coverage as they wait for the federal government's slow decisions and actions.

 

2. Provide $5.692 Million in Funding for Child Protective Services Workers

Caseloads are Too High

North Carolina has implemented a system reform effort in 52 of the 100 counties called the Multiple Response System (MRS). This new way of responding to reports of abuse and neglect has been shown to be more proactive and provide better outcomes through the interventions it employs to protect children and help families succeed.

 

• A caseload of 1:10 is needed to effectively implement MRS . A Duke University study of MRS recommended that an effective caseload size under MRS should be 1:8 worker/client ratio. We are striving to reach a 1:10 ratio which has been achieved in the 52 MRS counties but still have a 1:12 ratio in the remaining 42 counties.
• Caseloads that are too high contribute to turnover . The national turnover rates of child welfare staff which affect both recruitment and retention efforts has been estimated at between 30 percent and 40 percent annually nationwide, with workers average tenure being less than two years. The inability to retain staff contributes to the existing unmanageable caseloads.

• Caseload sizes must be reduced to effectively impact the well-being of families.   The amount of Caseloads are high, but workloads are even higher due to the growing complexity of each case . Substance abuse most often occurs with a finding of abuse or neglect, but mental illness, domestic violence, HIV/ AIDS, other poverty-related problems are also often present.
• For every change in caseworker, there is a significant increase in the time a child spends in the system. Caseworker consistency is essential to the successful outcome of child welfare services.

 

3. Support Funding for NC FAST

We need to modernize the antiquated DSS Welfare Automation system to help children and families and to meet federal requirements .

• NC FAST vastly benefits a multitude of programs and reduces the error in data collection. NC FAST is being developed to assist in Work First, Food Stamps, Child Welfare (CPS, Foster Care, Adoption, etc), Emergency Assistance, Medicaid, NC Health Choice, Child Care Subsidy Program, Adult and Family Services, Child Support. Currently, many of these programs require pen and paper tracking and data tabulations by hand that increases the risk of errors. An automated system reduces error and also allows more effective data collection to meet federal accountability requirements.
• NC FAST effectively streamlines work to increase productivity. The mountains of paperwork facing child welfare workers is astounding. Much time is spent filling out forms that then have to be duplicated if the child moves to different county. This is time lost that should be spent working directly with families.
• NC FAST allows statewide tracking of clients. In addition to the duplication of work, we face a much graver problem of losing children in the system. A child known to CPS in Wake County should be easily identified in the computer in Buncombe County . Abuse or neglect of a child should not be allowed to perpetuate simply by the inability to track a case from county to county.
• NC FAST allows systems within DSS and their community service partners to share information and in real time. In addition to tracking clients between counties, this system would allow us to track clients across programs within the DSS agency and with community service partners such as the schools and mental health, thus sharing and improving communication that results in time saved and better outcomes for clients.

4. Provide $ 2.8 Million for the Education Collaborative Program

Need More Qualified Child Protective Services Workers

The NC Child Welfare Collaborative prepares Bachelors of Social Work and Masters of Social Work student for employment in child welfare. A number of studies have documented the critical connections between training, competency, and quality services.

• Counties struggle to find qualified workers in Child Protective Services (CPS). Often times they are forced to hire workers with little or no experience in social services. This is demanding and emotional work that requires many skill sets. Studies have found that, in nearly 40 percent of the cases reviewed, insufficient or inadequate caseworker training or experience was a contributing factor in preventing family reunification.
• Child welfare staff with BSW and MSW degrees are more effective in developing successful permanency plans for children who are in foster care for more than two years.
• Social work degrees reduce turnover. More than 80% of child welfare workers who stay at their jobs beyond two years have completed at least one social work degree. Turnover is consistently higher in states that do not require a degree for child welfare positions and consistently lower in states that require a master's degree in social work. A 1990 study in Florida found that workers without educational preparation for child welfare work were most likely to leave within one year of being hired .
• Studies have shown that the lack of support of experienced supervisors is a leading cause of turnover. The average tenure of child welfare workers is less than two years. As a result, supervisors often have only three years of experience. New workers in the field often find they cannot receive the strong mentoring supervision and support they need.
• The two most decisive factors in employee retention are social work education and the climate of the work environment , including supportiveness of supervisors and peers. This was found in a 1998 study that examined the reasons child welfare workers remain in their positions longer than two years.
• Social work education reduces workers burnout, a major cause of staff turnover . A 1994 study in South Carolina found that educational preparation (p articularly graduate social work education) and intern placements helps prepare staff for the psychological and emotional strains of child welfare work.