Special Populations

Overview

Program/Practice Name: ACCESS Wisconsin Agency Name: Department of Health and Family Services (DHFS) Division of Health Care Financing

Contact Information:

ACCESS Wisconsin Department of Health and Family Services Division of Health Care Financing 1 W. Wilson Street Madison, WI 53701 (800) 362-3002 https://access.wisconsin.gov/

Autumn Arnold (608) 266-0157 arnolad@dhfs.state.wi.us

Type of Program/Practice: ACCESS Wisconsin is a fast and easy-to-use Internet tool that can help individuals determine the low- or no-cost health, nutrition, and other subsidy programs for which they might be eligible.

Description

Program/Practice Description: ACCESS Wisconsin also can be used to apply online for FoodShare, Medicaid/BadgerCare, and the Family Planning Waiver Program. Enrolled individuals also can obtain information on the status of their benefits for a number of programs, as well as report changes in income, expenses, and household composition online.

Innovations and Results: From the beginning of the initiative, DHFS worked with community partners and clients to develop a user-friendly tool. Through extensive use of focus groups, they were able to gain credibility not only among end users, but also among those responsible for developing the Web site. This level of understanding helped the team ensure that the end product met the needs of low-income Wisconsin residents. Although it was time consuming to engage community and client partners, the team built it into the development process, helping to shape the priorities for the infrastructure. In addition, the use of demonstration sites to pilot the program provided the team with readily available test sites and instantaneous feedback. There is also a dedicated Web page for community partners, providing a link to an online tutorial as well as informational and marketing materials.

Funding: So far, development of ACCESS has cost approximately $6 million. System maintenance likely will total $150,000 annually. The costs of the development and upgrades were funded jointly by the Food and Nutrition Service grant and the State. However, following the success of ACCESS, the State has provided funding for ongoing, incremental costs of maintenance and enhancements. The State also has hired a full-time, permanent outreach coordinator.

Implementation

Tips to Implementation: Branding the tool and the resultant promotional materials have been extremely helpful in spreading the word about ACCESS. Agencies across the State are encouraging DHFS to produce publications at each phase of the project to help highlight the new capabilities. Marketing materials can be ordered by agencies and community partners online at no charge. They also are distributed at statewide coalition meetings, and DHFS is looking to connect with other groups, such as emergency rooms and Federal Qualified Health Centers, that have not been tied into the ACCESS system in the past.

Keys to Success: During the tool design phase, several decisions proved to be key to the success of ACCESS:

• All materials are written at a fourth grade reading level. This style and the ample use of graphics make it easy to use for those who may be less familiar with Web applications or have difficulty reading.
• The screening tool should take a maximum of 15 minutes; the application should take between 30 and 40 minutes. This time limit was based specifically on focus group feedback and how long clients are willing to spend on various activities.
• The screening tool does not ask which public assistance programs the individual would like to screen for. The resulting eligibility list is based simply on the needs that arise through the applicant's answers. The purpose of this is to connect clients to benefits for which they may not know they were eligible.

Successes: A strong link was deliberately established between the State's electronic case management system, CARES, and ACCESS. This allows for a better flow of information between the applicant and the caseworker and should significantly reduce the need for data entry.

Challenges: With 72 counties and seven tribes responsible for implementing the program, there are often vast differences in the manner in which business is conducted. At the same time that DHFS launched ACCESS, the electronic case file system was put in place, further complicating implementation. Some sites have had little difficulty integrating the new practices, while others have struggled with adapting. DHFS has sent technical assistance consultants to help with issues as they arise. Team members also participate monthly in the Income Maintenance Advisory Committee, using it as a forum to address issues and share best practices, as well as gain credibility and buy-in from staff across the State.

Other Lessons Learned: Live demonstrations were critical in the early stages of implementation. However, as the project has continued, DHFS has become more selective in how it uses face-to-face resources. DHFS continues to visit programs to encourage ACCESS use, providing a quick demonstration, and an online tutorial is available for partners. Secondly, DHFS seems to be losing some potential clients between application and enrollment, which may be in part due to the requirement that applicants provide supporting documentation either through the mail or in person. The State is able to verify some information through data exchanges with other systems, including Social Security and Child Support. Other options, such as scanning, are being considered for documentation submission.

Tools

The following tools are associated with Access Wisconsin. Please send us an email at upitoolkit@blhtech.com for more information about these tools.

Short Introduction to ACCESS PowerPoint Presentation

Am I Eligible Fact Sheet

Apply for Benefits Fact Sheet

Check My Benefits Fact Sheet

Business Card – English

Business Card – Spanish

ACCESS Overview Flyer

Participant Information Brochure – English

Participant Information Brochure – Spanish

ACCESS Poster – English

ACCESS Poster – Spanish

Similar Types of Programs:

Access Florida

A growing number of States have implemented online applications. ACCESS Florida, which uses different software and a different business model than Wisconsin's ACCESS program, is another example of an online self-service tool.

ACCESS (Automated Community Connection to Economic Self-Sufficiency) cuts the processing time required for three economic assistance programs administered by the Department of Children and Families (DCF):

• Medicaid
• Food Stamps
• Temporary Cash Assistance

In addition to the traditional methods of applying by mail or fax, ACCESS Florida allows individuals to check eligibility and apply online through www.myflorida.com/accessflorida.

In addition, all local DCF customer service centers provide Internet access so individuals can apply online. It takes an average of 30 minutes to complete the application.

ACCESS Florida services 1.2 million Food Stamp households, 70,000 Temporary Assistance for Needy Families families, and 1.7 million Medicaid recipients. More than 90 percent of all applications are now received online. As a result, the State has been able to reduce staff, saving $83 million annually in administrative costs.

Florida's ACCESS program was named a winner of the Innovations in American Government Award on September 24, 2007, from the Ash Institute for Democratic Governance and Innovation.

Overview

Program/Practice Name: Family Services Team (FST)1

Agency Name: El Paso County (Colorado) Department of Human Services Office of Employment and Family Support

Contact Information: Rick Bengtsson, richardbengtsson@elpasoco.com (719)444-5535

Type of Program/Practice: FST works collaboratively to provide financial and support services through child only grants for relative caregivers.

1 FST formerly was known as the Family Support Team. The name change took effect in 2007 when FST was put under the administration of the Office of Employment and Family Support.

Description

Program/Practice Description: FST provides financial eligibility and casework services to relative caregivers with a focus on the family as a whole. This team identifies and supports the needs of child only cases in line with Temporary Assistance for Needy Families (TANF) objectives, and uses TANF funds to provide prevention and supportive services to these families. The goal is to help connect relative caregivers with the support and services they need before they have to enter into the child welfare system, which can be time-consuming and more intrusive. Kinship services provided by FST include a TANF child only payment, Medicaid for the child, special funding for specific financial needs on a case-by-case basis, subsidized permanent custody, and other supportive services as needed. FST also operates the Warm Line, which individuals can call to obtain information on available resources or talk to caseworkers or a grandparent advocate. In addition, FST facilitates three biweekly support groups that are designed to offer education and emotional support for grandparents. One of the support group facilitators is under contract through the Department of Human Services in collaboration with Community Partnership for Child Development (Head Start) and the other two are community-based facilitators.

Innovations and Results: This program is unique in that it works to address the needs of relative caregivers using TANF funds before they have to enter into the formal child welfare system. This program is an example of the service integration focus of El Paso County Human Services. Service integration of child welfare and TANF has:

• Reduced the number of families on welfare without using punitive approaches;
• Reduced the number of children and youth in foster care; and
• Increased the safety of children.

Coordinating child welfare caseworkers with TANF technicians gives families access to a broader array of services and resources for both TANF and child welfare. As a result, FST is better able to serve high-need clients through service integration and meets requirements of multiple programs through one case plan.

Funding: The program provides supportive services, above basic cash assistance, to grandparents raising grandchildren or caregivers raising relative children. The strategy is to have caseworkers and technicians evaluate a family's needs and provide financial assistance accordingly, instead of giving caregivers a set amount of money every month.

Staffing: FST was one of the first blended staff units at El Paso County Department of Human Services. It is composed of a supervisor, one child welfare caseworker experienced with working with families to provide supportive services, a grandparent advocate, and four TANF technicians with financial program experience focusing on self-sufficiency. The grandparent/relative advocate provides families with referrals to community resources and helps them navigate through the human services, school and mental health systems. The advocate provides outreach, speaking at human services agencies in the community sharing information about this program and how we might benefit their clients.

Implementation

Tips to Implementation: Service integration of child support, adult programs, and child only cases has allowed the program to serve the family as a whole and provide services to families based on their needs. Also, co-locating caseworkers with TANF technicians increased coordination and collaboration to serve families more effectively and efficiently. FST has worked in collaboration with other programs in the division to preserve flexibility and address the needs of clients working toward the ultimate goal of self-sufficiency.

Keys to Success:

• Using block grant money has enabled the division to use funds for preventive programs and more flexible support and services.
• Once this program was operational, a brochure was created and distributed throughout the division and to the public so people were aware of the services offered by FST. Quarterly newsletters are sent via e-mail or letter mail to grandparents and relative caregivers in the community who have been served by FST; the mailing list contains approximately 1,200 households.
• Flexibility in the program has been critical. The program was designed to use services to address the specific needs of clients and does not have a list of procedures and processes for staff.
• Emphasis is placed on the division working as a whole to achieve its mission "to strengthen families, assure safety, promote self-sufficiency, and improve the quality of life" in the community.

Challenges:

• Reporting: Since FST provides such diverse services, it is difficult to report on the services provided and document outcomes as a result of FST activities.
• Staffing: Managing a growing caseload and providing adequate staffing continue to be challenges.

Tools

The following tools are associated with Family Services Team (FST). Please send us an email at upitoolkit@blhtech.com for more information about these tools.

TANF and Child Welfare Service Integration Fact Sheet

Family Services Team Relative Caregivers How To: (and Other Helpful Hints)

El Paso County Department of Human Services MOU - Kinship Family Assessment and Family Services Team

Kinship Unit Facts

Kinship Unit Information Sheet

Overview

Program/Practice Name: New Jersey's Kinship Navigator Program

Agency Name: New Jersey Department of Children and Families

Contact Information:

Diana Kelley Regional Coordinator Kinship Navigator Program New Jersey Department of Children and Families 50 East State Street P.O. Box 717 Trenton, NJ 08625 (609) 888-7398 diana.kelley@dcf.state.nj.us

Type of Program/Practice: The Kinship Navigator program partners with 211, a Human Services Directory for all of New Jersey, to provide services to relative caregivers. Relative caregivers can call this hotline to make an application for services with the Kinship Navigator program and to receive information and referral for other services throughout New Jersey.

Description

Program/Practice Description: The Kinship Navigator program was developed to provide linkages to government and community resources for relative caregivers. This toll–free service (211) helps relative caregivers identify available resources and advocates on their behalf to access those services. In addition, the program helps administer support programs created specifically for kinship caregivers, including cash assistance, child care subsidies, and wraparound services.

Background/Program History: The first programs New Jersey implemented were the Kinship Child Care Subsidy Program and the Kinship Wraparound Program. Caregivers younger than age 60 and working, preparing for work or disabled need to meet the income limit of 350% of the Federal poverty level. Caregivers age 60 or older need to meet the income limit of 500% of the Federal poverty level.

Later, New Jersey passed legislation called Kinship Legal Guardianship specifying that relative caregivers must have the child residing with them for at least 1 year. The court makes the ultimate decision on the placement in the best interest of the child and the relative becomes the legal guardian of the child upon approval. Legal guardianship is unique because it transfers some parental rights to caregivers without terminating all biological parental rights. Legal guardianship, as opposed to adoption, allows caregivers to access services for the child, provide a more permanent plan for the child, and access the kinship subsidy to offset the financial costs associated with raising a child.

Innovations and Results: Relative caregivers who are eligible to have legal guardianship also qualify to receive the kinship care subsidy; however, they must be below 150 percent of the Federal poverty level and not be involved with the Department of Youth and Family Services (DYFS). This subsidy includes $250 a month and Medicaid benefits. Other caregivers have access to additional services through the Kinship Navigator program. Also, New Jersey has a subsidy program through Child Protective Services, which is available to relative caregivers of children placed in their homes by DYFS. These grandparents receive a monthly support payment for up to 15 months. The caregiver must cooperate with the permanency plan, which may include adoption, legal guardianship, legal custody, or a return home.

Implementation

Support Services Available:

• Help paying for child care
• Referrals to grand–parenting and family support groups
• Help obtaining medical coverage and services
• Assistance with child support collection
• Housing assistance
• Help paying for legal services and fees
• Help paying for furniture (for example, a bed, computer, or computer supplies for the child)
• Tutoring services for the children in care
• Help paying for summer camp for the child
• Financial services

Tools

"There are no tools associated with this program."

Overview

Program/Practice Name: Relative Caregiver Program (RCP)

Agency Name: Tennessee Department of Children's Services

Contact Information:

Carla Aaron Executive Director, Child Safety Tennessee Department of Children's Services 436 Sixth Avenue North Nashville, TN 37243 Phone: (615) 741-8278 Carla.Aaron@tn.gov

Betty Smith Program Coordinator, Relative Caregiver Program Tennessee Department of Children's Services 436 Sixth Avenue North Nashville, TN 37243 Phone: (615) 253-2397 Betty.Smith@tn.gov

Type of Program/Practice: RCP is a public/private collaboration designed to support children who are not able to be raised by their parents and are being cared for by grandparents, aunts, uncles, and other extended family members.

Description

Program/Practice Description: The Relative Caregiver Program (RCP) was developed with the guiding principle that in general, abused or neglected children are best served by living with another family member, rather than by going into foster care. To qualify for RCP, a relative caregiver must be related to the child by blood, marriage, or adoption; live in the areas that the program serves; and live below 200 percent of the Federal poverty guideline. The project began as a pilot in 2001, and then became a formal program in 2004. RCP has specific outcomes that must be met each year, including requirements such as 50 percent of referrals originating from the Department of Children's Services (DCS), the Department of Health Services, or juvenile court, and 80 percent of families progressing to independence.

Background/Program History: RCP is funded completely by the State, with a budget of around $4 million. In an innovative use of funds, RCP provides support services, including emergency or start-up financial assistance if a caregiver meets the requirements. Also under these support services, RCP provides material assistance for essential items such as beds, clothing, and household appliances through donations or direct purchases when needed. Over the course of the program, RCP allocation of money has changed in response to funding and needs. RCP has shifted additional program dollars toward disseminating information on the support services to reach more eligible families.

Innovations and Results: Instead of providing ongoing daily service delivery, the Department of Children's Services (DCS) contracts with private community agencies to provide support services across the state. Not only does this outsourcing save the State staff time and resources, but also these community agencies are often viewed more positively by the families seeking services and the public at large. To support the private agencies in operating the RCP program, DCS provides training, monitoring, group meetings, and technical assistance. During 2010 year, the RCP served 3901 children and 2618 caregivers statewide. One of the state's required outcomes for the RCP program is that 85 percent of children participating in the program remain in the continuous care of the caregiver; as a result, less than 5 percent of children from the RCP program have entered state custody. By offering supportive services, RCP helps to keep families intact.

Implementation

Tips to Implementation: When implementing this type of program, States should consider:

• Working with local service groups to outsource and deliver needed services to youth and families, both for cost-effective reasons and for credibility.
• Developing partnerships and collaborations between State and local, as well as between community and faith-based, organizations.
• Form a statewide leadership committee. Tennessee started a statewide kinship committee composed of legislators, caregivers, social workers, State government department leaders, law enforcement, faith-based organizations, and other community leaders. This committee later merged with the State mandated Community Advisory Boards (CABs) to better utilize the time and resources of the shared members.

Keys to Success:

• Partnerships and collaborations between State and local, as well as between community and faith-based organizations, are a hallmark of RCP. For example, in Nashville, the groups involved in RCP met with community and faith-based organizations to map the services offered to youth and families to learn where their strengths and gaps were. Such collaboration is often new and results in better alignment of services for these youth and families.

Successes: The major success of this program is increasing family stability and preventing children from coming into State custody. RCP promotes greater community buy-in and support for at-risk children and families. Further, RCP encourages collaborations at many levels. RCP represents not just a highly successful client model, but also a program with significant savings of State dollars. For example, without this program, children possibly would be child protective referrals, which is significantly more expensive for the State than the RCP program.

Tools

The following tools are associated with Relative Caregiver Program (RCP). Please send us an email at upitoolkit@blhtech.com for more information about these tools.

Relative Caregiver Brochure

Explains the process of becoming a family caregiver and introduces the Relative Caregiver Program

Relative Caregiver Program Newsletter

Publication with resources and important information for the Tennessee relative caregiver network