A consultant that evaluated privatization of a failing Nebraska child welfare system has concluded the reform effort is still not "experiencing any measurable benefits."
Hornby Zeller Associates' evaluation focused on the one remaining private contractor, a pilot project in the Omaha area in which Nebraska Families Collaborative provides child welfare services and case management.
The evaluation was authorized by a bill (LB660) passed in 2014, introduced by Omaha Sen. Bob Krist, chairman of the Legislature's Executive Board. It cost about $30,000 to do the study, Krist said.
The bill extended the Nebraska Families Collaborative contract and called for an evaluation on whether child welfare case management should be returned to the Department of Health and Human Services and whether private contractors should continue to be used in the process.
The study found costs were less for Nebraska Families Collaborative compared to the department's costs in the remaining service areas. The collaborative's costs were $48.10 per client per day. The state's comparative costs were $74.17.
Krist said one reason the state's costs were higher could be that privatization destroyed all the infrastructure of providers, especially in rural areas of the state, and they are just being rebuilt.
While compliance with the rules and regulations governing casework with families and children seems to be "somewhat better" in the private agency than in those service areas under HHS, the consultant found there is no measurable difference in the outcomes for those families and children.
Privatization, which started in earnest in 2009 with five lead contractors, caused disruption and dissension, Hornby Zeller found.
But it is not clear what direction the state should now take, the consultant concluded.
Three options were offered: Stay the course, end the contract with the collaborative and return all functions to the department, or choose a new model entirely for the roles of the public and private sectors.
The consultant called the first option the path of least resistance.
The motivation for ending the contract would seem obvious, the consultant said, because privatization promised better outcomes at a lower cost and that hasn't happened.
In retooling the reform effort, if the change would be to increase the proportion of children being served in their own homes, the focus should be on what is required to achieve that goal, not on who can do it best, the consultant said.
"The only real argument for maintaining the structure in Douglas and Sarpy counties is the need to avoid further disruption to the system," the consultant said.
Dave Newell, president and CEO of the collaborative, said he was disappointed in the report and he would, of course, opt for staying the course. Children and families in Douglas and Sarpy counties are achieving the best child welfare results in their history, he said, and the collaborative is needed to continue to build on the progress.
"Despite NFC only serving the Eastern Service Area, as a whole, since March 2012, our region has been transformed from being the historically lowest performing child welfare system in Nebraska to being on par with or better than the other service areas for the very first time," Newell said.
Krist predicted the decision on how to move forward will be a combination of all three options.
He introduced a bill this session (LB502) to establish a pilot project in Douglas County to create a family court program that would work directly with families to put them back on track.
The state named Courtney Phillips of Louisiana the new HHS chief executive officer on Friday. She will begin her job April 2. Krist is hoping new directors of the division of child and family services and Medicaid will be named as soon as possible.
"There's a bunch of missing players right now, I think, who need to read that report and then we need to get together and talk," he said.