HOUSE BILL NO. 1837 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE KELLEY.
4025H.01I JOSEPH ENGLER, Chief Clerk
AN ACT To repeal section 210.112, RSMo, and to enact in lieu thereof one new section relating to case worker caseloads.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Section 210.112, RSMo, is repealed and one new section enacted in lieu 2 thereof, to be known as section 210.112, to read as follows: 210.112. 1. It is the policy of this state and its agencies to implement a foster care and 2 child protection and welfare system focused on providing the highest quality of services and 3 outcomes for children and their families. The department of social services shall implement 4 such system subject to the following principles: 5 (1) The safety and welfare of children is paramount; 6 (2) All providers of direct services to children and their families will be evaluated in a 7 uniform, transparent, objective, and consistent basis based on an evaluation tool established in 8 this section; 9 (3) Services to children and their families shall be provided in a timely manner to 10 maximize the opportunity for successful outcomes, and such services shall be tracked and 11 routinely evaluated through a quality assurance program; 12 (4) Any provider of direct services to children and families shall have the appropriate 13 and relevant training, education, and expertise to provide the highest quality of services 14 possible which shall be consistent with federal and state standards; 15 (5) Resources and efforts shall be committed to pursue the best possible opportunity 16 for a successful outcome for each child. Successful outcomes may include preparing youth 17 for a productive and successful life as an adult outside the foster care system, such as
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. HB 1837 2
18 independent living. For those providers that work with children requiring intensive twenty- 19 four-hour treatment services, successful outcomes shall be based on the least restrictive 20 alternative possible based on the child's needs as well as the quality of care received; and 21 (6) All service providers shall prioritize methods of reducing or eliminating a child's 22 need for residential treatment through community-based services and supports. 23 2. (1) In conjunction with the response and evaluation team established under 24 subsection 3 of this section, as well as other individuals the division deems appropriate, the 25 division shall establish an evaluation tool that complies with state and federal guidelines. 26 (2) The evaluation tool shall include metrics supporting best practices for case 27 management and service provision including, but not limited to, the frequency of face-to-face 28 visits with the child. 29 (3) There shall be a mechanism whereby providers may propose different evaluation 30 metrics on a case-by-case basis if such case may have circumstances far beyond those that 31 would be expected. Such cases shall be evaluated by the response and evaluation team under 32 subsection 3 of this section. 33 (4) Data regarding all evaluation metrics shall be collected by the division on a 34 monthly basis, and the division shall issue a quarterly report regarding the evaluation data for 35 each provider, both public and private, by county. The response and evaluation team shall 36 determine how to aggregate cases for the division and large contractors so that performance 37 and outcomes may be compared effectively while also protecting confidentiality. Such 38 reports shall be made public and shall include information by county. 39 (5) The standards and metrics developed through this evaluation tool shall be used to 40 evaluate competitive bids for future contracts established under subsection 4 of this section. 41 3. The division shall create a response and evaluation team. Membership of the team 42 shall be composed of five staff members from the division with experience in foster care 43 appointed by the director of the division; five representatives, one from each contract region 44 for foster care case management contracts under this section, who shall be annually rotated 45 among contractors in each region, which shall appoint the agency; two experts working in 46 either research or higher education on issues relating to child welfare and foster care 47 appointed by the director of the division and who shall be actively working for either an 48 academic institution or policy foundation; one juvenile officer or a Missouri juvenile justice 49 director to be appointed by the Missouri Juvenile Justice Association; and one juvenile or 50 family court judge appointed by the supreme court. The division shall provide the necessary 51 staffing for the team's operations. All members shall be appointed and the team shall meet for 52 the first time before January 1, 2021. The team shall: HB 1837 3
53 (1) Review the evaluation tool and metrics set forth in subsection 2 of this section on 54 a semiannual basis to determine any adjustments needed or issues that could affect the quality 55 of such tools and approve or deny on a case-by-case basis: 56 (a) Cases that a provider feels are anomalous and should not be part of developing the 57 case management tool under subsection 2 of this section; 58 (b) Alternative evaluation metrics recommended by providers based on the best 59 interests of the child under subsections 2 and 5 of this section; or 60 (c) Review and recommend any structure for incentives or other reimbursement 61 strategies under subsection 6 of this section; 62 (2) Develop and execute periodic provider evaluations of cases managed by the 63 division and children service providers contracted with the state to provide foster care case 64 management services, in the field under the evaluation tool created under subsection 2 of this 65 section to ensure basic requirements of the program are met, which shall include, but are not 66 limited to, random file review to ensure documentation shows required visits and case 67 management plan notes; and 68 (3) Develop a system for reviewing and working with providers identified under 69 subdivision (2) of this subsection or providers who request such assistance from the division 70 who show signs of performance weakness to ensure technical assistance and other services 71 are offered to assist the providers in achieving successful outcomes for their cases. 72 4. The children's division and any other state agency deemed necessary by the 73 division shall, in consultation with service providers and other relevant parties, enter into and 74 implement contracts with qualified children's services providers and agencies to provide a 75 comprehensive and deliberate system of service delivery for children and their families. 76 Contracts shall be awarded through a competitive process and provided by qualified public 77 and private not-for-profit or limited liability corporations owned exclusively by not-for-profit 78 corporations children's services providers and agencies which have: 79 (1) A proven record of providing child welfare services within the state of Missouri 80 which shall be consistent with the federal standards, but not less than the standards and 81 policies used by the children's division as of January 1, 2004; and 82 (2) The ability to provide a range of child welfare services including, but not limited 83 to, case management services, family-centered services, foster and adoptive parent 84 recruitment and retention, residential care, in-home services, foster care services, adoption 85 services, relative care case management, planned permanent living services, and family 86 reunification services. 87 88 No contracts under this section shall be issued for services related to the child abuse and 89 neglect hotline, investigations of alleged abuse and neglect, and initial family assessments. HB 1837 4
90 Any contracts entered into by the division shall be in accordance with all federal laws and 91 regulations, and shall seek to maximize federal funding. Children's services providers and 92 agencies under contract with the division shall be subject to all federal, state, and local laws 93 and regulations relating to the provision of such services, and shall be subject to oversight and 94 inspection by appropriate state agencies to assure compliance with standards which shall be 95 consistent with the federal standards. 96 5. The division shall accept as prima facie evidence of completion of the 97 requirements for licensure under sections 210.481 to 210.511 proof that an agency is 98 accredited by any of the following nationally recognized bodies: the Council on 99 Accreditation [of Services,] for Children and Families, Inc. (COA); the Joint Commission 100 [on Accreditation of Hospitals]; or the Commission on Accreditation of Rehabilitation 101 Facilities. 102 6. Payment to the children's services providers and agencies shall be made based on 103 the reasonable costs of services, including responsibilities necessary to execute the contract. 104 Any reimbursement increases made through enhanced appropriations for services shall be 105 allocated to providers regardless of whether the provider is public or private. Such increases 106 shall be considered additive to the existing contracts. In addition to payments reflecting the 107 cost of services, contracts shall include incentives provided in recognition of performance 108 based on the evaluation tool created under subsection 2 of this section and the corresponding 109 savings for the state. The response and evaluation team under subsection 3 of this section 110 shall review a formula to distribute such payments, as recommended by the division. 111 7. The division shall consider immediate actions that are in the best interests of the 112 children served including, but not limited to, placing the agency on a corrective plan, halting 113 new referrals, transferring cases to other performing providers, or terminating the provider's 114 contract. The division shall take steps necessary to evaluate the nature of the issue and act 115 accordingly in the most timely fashion possible. 116 8. The division shall ensure that no case worker has more than twenty active 117 cases assigned to him or her at one time. 118 9. By July 1, 2021, the children's division shall promulgate and have in effect rules to 119 implement the provisions of this section and, pursuant to this section, shall define 120 implementation plans and dates. Any rule or portion of a rule, as that term is defined in 121 section 536.010, that is created under the authority delegated in this section shall become 122 effective only if it complies with and is subject to all of the provisions of chapter 536 and, if 123 applicable, section 536.028. This section and chapter 536 are nonseverable and if any of the 124 powers vested with the general assembly pursuant to chapter 536 to review, to delay the 125 effective date, or to disapprove and annul a rule are subsequently held unconstitutional, then HB 1837 5
126 the grant of rulemaking authority and any rule proposed or adopted after August 28, 2004, 127 shall be invalid and void. 128 [9.] 10. A provision in a service provider contract in which the state is indemnified, 129 held harmless, or insured for damages, claims, losses, or expenses arising from any injury, 130 including, but not limited to, bodily injury, mental anguish, property damage, or economic or 131 noneconomic damages or loss caused by or resulting from the state's negligence, in whole or 132 in part, shall be void as against public policy and unenforceable. As used in this subsection, 133 "service provider contract" means a contract, agreement, or understanding between a provider 134 of services and the division regarding the provision of services. ✔
Statutes affected: