Social services costs skyrocket

WABASHA — Tim Hunter is used to the call.

As the social services supervisor for Wabasha County with 10 years of experience in family and child social services, Hunter has fielded his share of late-night and weekend requests to come evaluate a family situation and see if a child is in danger.

On those unfortunate times when the child is in a dangerous situation, Hunter or one of his colleagues takes that last resort step to place a child in foster care. The term is out-of-home placement, and it is one of the most costly mandates counties face.

Starting in 2017, counties are facing a new cost with out-of-home placements: Making sure social workers are available to respond and evaluate within 24 hours. In a county like Wabasha, where Hunter supervises three social workers focused on child protection plus an intake specialist, that means spreading the resources thin.

"I don't think safety was that much of an issue," Hunter said. While the state had not mandated 24/7 availability for social workers, the county's social services department worked with law enforcement to make sure cases that required immediate assistance were covered.

"Our law enforcement officers here have been responsive to the child's safety. That piece hasn't changed. What's changed is how quickly we will assess the family."

Rising Cost of Care

In 2016, out-of-home placements represented 54 percent of the social service levy in Wabasha County, or $951,245 out of $1,745,591, said Social Service Director John Dahlstrom. That cost has risen over the years as the state requires more and more from the counties but has not added funds to help cover those services.

Statewide, local government picks up about 40 percent of all costs related to out-of-home placements, said Matt Hilgart, general government policy analyst with the Association of Minnesota Counties. "Nationwide, most child protection is funded through state and federal agencies," he said. "It's an imperative service. Minnesota is one of few states where there's a significant local share."

The problem with mandating service through the counties, Hilgart said, is that the state's portion of funding, county program aid, often gets cut as more funding requirements come out. "In times of deficit, the state cuts its share to balance the budget."

The result, Hilgart said, is counties saying enough is enough.

Historically, Dahlstrom said Wabasha County might have had a year where out-of-home placements cost as much as $800,000, but it was generally closer to $400,000. So when costs hit nearly $1 million in 2013, "We thought it was a blip and would go down. But it hasn't gone down," he said. "It has definitely slowly crept up."

The blip, in fact, was 2015 when placement costs dropped to $636,025, said County Administrator Michael Plante. "We continue to need to project $950,000 of levy impact for out-of-home placements," he said. "A big driver is a lack of cost-effective solutions for children with higher care needs."

Winona County Commissioner Marcia Ward said her county has noticed the same problem. "Part of it is the cost keeps increasing at a number of places where these kids can be sent," she said. "Part of it is getting new foster parents licensed."

Like Wabasha County, Winona County is facing the cost increase of having a staff member on call during nights and weekends. "They've changed the rules as far as having to respond," Ward said. "All our people are pretty much union so, yes, it does add something to the cost."

Like Wabasha County, Winona County is looking at close to $1 million in the budget for the program, Ward said.

Chipping In

All of this and more is covered by the state through county program aid, the state's way of chipping in for unfunded or underfunded programs mandated by the state. For Wabasha County, that means $830,252 to pay for out-of-home placements, mental health hospital stays, costs associated with MNsure, the state's health insurance marketplace, and much more.

The rising cost of care — Dahlstrom said it's not the number of cases that's increasing, it's the cost of care facilities or the increased time in foster care that is being required that has driven up costs through 2016 -- made Wabasha County the 10th-highest average cost per placement in the state.

And with the 24-hour coverage rule in place, small counties like Wabasha face the task of spreading limited staff resources across the calendar.

"We can't have someone fully staffed," Dahlstrom said. In the last three years, there have been maybe a half a dozen calls on the weekends that would require that extra person. "If we get a call after hours or on weekends, it goes through dispatch and we pay overtime."

To meet the mandate, the county will set up an on-call system where staff are paid around $2.25 an hour on weekends to be available if needed, Dahlstrom said. If a social worker is needed on the scene, that person is reached and paid overtime for taking the call. "We're relying on a call tree, but people have lives."

"It puts a little more pressure on our county social workers to be available in those hours," Hunter said. "It's a staffing issue and a staff-retention issue."

And that, he said, will cost the county more money.