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SECOND REGULAR SESSION
HOUSE BILL NO. 1837
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE KELLEY .
4025H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o repeal section 210.1 12, 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Section A. Section 210.1 12, RSMo, is repealed and one new section enacted in lieu
2 thereof, to be known as section 210.1 12, to read as follows:
210.1 12. 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 ef forts 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
EXPLANA TION — 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.
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 dif ferent 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 lar ge contractors so that performance
37 and outcomes may be compared ef fectively 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 staf f 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 of ficer 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 staf fing 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:
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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 offer ed 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.
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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 210.51 1 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 mor e 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 ef fective 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 ef fective date, or to disapprove and annul a rule are subsequently held unconstitutional, then
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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.
✔
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