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County council HHSA committee hears update as foster care costs soar

November 4, 2019
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The October 16 meeting of the Cuyahoga County Health, Human Services and Aging committee saw presentations from two community organizations, and also considered several contracts, one of which expands the number of providers in the foster-care system.

 The number of children in foster care has soared to more than 2,900 children currently in out-of-home care, the highest number in a decade. The number of children in foster care has increased by more than 1,000 since 2017.

The first contract request was to amend a master contract for out-of-home placement and foster care services. Christine Alexander, of the Cuyahoga County Department of Health and Human Services and Jackie McCrae, Deputy Director of the Department of Children and Family Services, testified in front the committee. The county currently uses a master contract, worth $49.2 million annually, which includes multiple foster-care service providers. The number of children in foster care has soared to more than 2,900 children currently in out-of-home care , the highest number in a decade. The number of children in foster care has increased by more than 1,000 since 2017. Due to this increase, the money allocated at the beginning of the year is running out.The county will add nearly $11.6 million to the contract to fund the foster care system through the end of 2019, so foster care costs for this year will total $61.7 million. The county will also allocate additional dollars in preparation for next year. Additionally, the county will propose to extend the master contract to the end of 2020, and proactively add $11.5 million for next year. Seventy percent of the total foster care cost of $61.7 million comes from the Cuyahoga County Health and Human Services levy and the remaining 30 percent comes from federal funding. The master contract currently works with 47 providers. The contract extension would add three providers (Anne Grady Services, Sequel Pomegranate Health Systems, LLC and The Buckeye Ranch), to bring the total number of providers to 50. Currently available in-county foster care placement facilities are full, and 34 percent of children are placed outside of Cuyahoga County, with 13 kids (4.4 percent) placed out of the state, one as far away as Oklahoma. It is also important to note that the state did add money for child welfare in the most recently passed state budget, which will aid counties that face significant increases in the number of children in foster care.  

Councilmembers asked a few clarifying questions. Councilman Dale Miller made the observation that if the foster care system contract costs $43 million, when that is combined with the annual subsidy to Metro Health ($32 million) and the county health and human service levy funds that the Alcohol Drug Addiction and Mental Health Services (ADAMHS) Board receives ($39 million), those three allotments make up roughly half of all of the health and human service levy funds. Everything else funded by HHS levy funding is competing for the remaining half. The contract was passed out of committee under second reading suspension, meaning that the contract did not need to be heard at three straight committee meetings, before being moved to the full council.

 Currently available in-county foster care placement facilities are full

The next contract was a one-year extension worth $1,953,105 with the Community Social Services Programs (CSSP). Christine Alexander, from the Department of Health and Human Services on behalf of the Department of Senior and Adult Services and Tracey Mason, Administrator for the Department of Senior and Adult Services, testified about a master contract that provides funding to senior centers across the county. Services provided at these centers include things like congregate meals, dancing and computer classes. Thirty responders initially replied to the April 2018 RFP. Of those 30 applicants, 26 vendors were selected. Paul Porter, Contract Manager for the Department of Health and Human Services, joined Alexander to explain how the vendors were selected, and how the county keeps track of where and how the dollars are spent by the various providers.  

Council Vice President Pernel Jones asked for clarity on what criteria is used to determine where funding goes. Porter explained that the county allocated funds based on scoring. This prompted Jones to wonder aloud why money is sent to more affluent communities like Solon or Strongsville, who may be better able to financially support their seniors locally than other cities that don’t have those resources. Wendy Sutton, Director of Community Partnership on Aging, which includes cities such as South Euclid, Lyndhurst, Mayfield Village, Mayfield Heights and Highland Heights, testified later in the hearing that often county funding is a critical complement to local municipalities that use local to support seniors in their cities. Zulma Zabala, East End Neighborhood House, Inc. President and CEO, and a Community Solutions board member, testified in support of the CSSP program, stating that more and more seniors will need services in the future, and this county funding is critical to meet those needs. The contract was passed out of committee under second reading suspension, meaning that the contract did not need to be heard at three straight committee meetings, before being moved to the full council.  

The final contract under consideration was with Lutheran Metropolitan Ministry (LMM) for the Adult Guardianship program. Once again, Alexander spoke on behalf of the Department of Health and Human Services, requesting approval of the contract. She explained that the contact is a joint contract between LMM and Cuyahoga County Probate Court and will run from January 1, 2020 to December 31, 2021. Farmer testified that adult guardianship serves indigent individuals that have been victims of abuse, neglect or exploitation and for whom there is no appropriate family member to serve as the guardian. These individuals have been deemed “incompetent” by Probate Court and are referred to LMM.  

The contract was the result of an RFP that was issued in July 2019. LMM was the only respondent. LMM has provided adult guardianship for 30 years, and providing the service for DSAS and Probate Court referrals for more than 10 years. The funding for the contact has been flat since 2014. The upcoming two-year contract provides a slight increase in total funding.  

Kendra Daniel, from Lutheran Metropolitan Ministry, testified the that the program consists of a program supervisor, paid LMM members, as well as several screened and trained volunteers who work with seniors who are involved in the program. The volunteers become legal guardians for those seniors and assist in decision-making.  

The committee also heard two presentations. The first was from advocates on the need to increase support for efforts promoting digital inclusion in Cuyahoga County. The second presentation was from an advocacy group that wants to raise the pay for individuals who serve as guardians ad litem, court-appointed individuals who serve as representatives for minor children or incapacitated adults. The advocates described how the large increase of children in the foster care system is creating a shortage of people who can serve as guardians ad litem.  

The committee was then adjourned.  

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