Effective Services for Young Children Report of a Workshop (1991) / Chapter Skim
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State Financing Strategies that Promote More Effective Services for Children and Families
State Financing Strategies that Promote More Effective Services for Children and Families
Pages 65-73
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From page 65... ...
This paper reviews several financing innovations that states are using to improve child and family services. It discusses the overall approach that underlies states' efforts; identifies specific fiscal strategies; and raises issues related to states' future development of financing strategies.
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From page 66... ...
Since dollars are never sufficient for mandated services, allocations for developmental and preventive services remain even smaller in the context of overall service system expenditures. States' new fiscal strategies attempt to restructure funding so that it supports the service delivery principles set forth above.
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From page 67... ...
Fiscal changes require parallel alterations in service governance and service delivery technologies if they are to achieve states' goals for more effective service systems. For example, as state agencies pool funds in order to achieve a common goal, they must also develop new, joint service definitions, new contracting procedures, and new interagency referral mechanisms.
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From page 68... ...
Local agencies contracting for this service will work toward common outcomes, use common referral procedures, and accept common standards to assess service quality. Most important, the state's achievement of uniform strategies for family preservation services is leading state officials to consider more extensive joint financing and cross-agency service delivery.
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From page 69... ...
A broader attempt to make funding more flexible and shift authority to the local level is represented by Iowa's decategorization initiative, which involves a wider array of children and family funding sources. In 1987, the Iowa General Assembly passed legislation directing the state Department of Human Services to select two counties as demonstration sites for decategorizing child welfare services, with the intent of allowing the local jurisdictions to use these funds over a three-year period to develop a more client-centered as opposed to funding-stream-driven system.
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From page 70... ...
In those states, generalist family service workers use these dollars to buy goods and services (rent deposits, emergency food, alcoholism treatment, emergency child care, etc.) as needed to stabilize families.
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From page 71... ...
As with other entitlement funds, Medicaid's funding potential must be examined in the context of the service delivery structure that a state is trying to establish. The second way in which states are using entitlement funding to improve service systems is by claiming entitlements more aggressively for costs previously paid by state and local funds, thereby freeing those state and local funds for reinvestment in service systems improvements.
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From page 72... ...
The second issue for states seeking improved service financing is how funding can be provided through a more stable, entitlement-oriented mechanism. Part of the pressure for broader use of Medicaid financing for children and family services comes from states' desire to shift away from social service funding sources to an ensured entitlement financing base.
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From page 73... ...
STATE FINANCING STRATEGIES 73 Fueled by simultaneous pressures to control costs and improve services, states are likely to continue their financing innovations. The challenge will be to direct these new approaches in a way that, in fact as well as in theory, makes financing structures more rather than less useful to families, and more rather than less likely to promote effective outcomes.
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