House Actions

Committee Report REGULAR CALENDAR

April 11, 2018

The Majority of the Committee on Finance to which was referred SB 582-FN,

AN ACT (New Title) authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor. Having considered the same, report the same with the following resolution: RESOLVED, that it is INEXPEDIENT TO

LEGISLATE.

Original: House Clerk Cc: Committee Bill File Original: House Clerk Cc: Committee Bill File

MAJORITY COMMITTEE REPORT

Committee: Finance Bill Number: SB 552-FN Title: (New Title) authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor. April 11, 2018 Consent Calendar: REGULAR Recommendation: INEXPEDIENT'TO'LEGISLATE-'

STATEMENT OF INTENT

This bill makes an appropriation of $100,000 to the Department of Health and Human Services (DHHS) to conduct a study to determine the appropriate case load for child protection staff. The appropriate caseload is already known, both from national standards and a New Hampshire-specific study in 2016. The bill spends $1.1 million to create 15 new positions in the Division for Children, Youth and Families (DCYF) and an additional $1.1 million for fund rate increases for foster care and adoption programs. Division III of the Finance committee received a number of bills dealing with DCYF and has decided to address them in SB 592. Therefore, as sections of this bill will be moved to SB 592, House Finance believes SB 582 is no longer necessary.

Vote 15-10.

Rep. David Danielson FOR THE MAJORITY

Original: House Clerk Cc: Committee Bill File REGULAR CALENDAR

Finance SB 582-FN, (New Title) authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor. MAJORITY: INEXPEDIENT TO LEGISLATE. MINORITY: OUGHT TO PASS. Rep. David Danielson for the Majority of Finance. This bill makes an appropriation of $100,000 to the Department of Health and Human Services (DHHS) to conduct a study to determine the appropriate case load for child protection staff. The appropriate caseload is already known, both from national standards and a New Hampshire-specific study in 2016. The bill spends $1.1 million to create 15 new positions in the Division for Children, Youth and Families (DCYF) and an additional $1.1 million for fund rate increases for foster care and adoption programs. Division III of the Finance committee received a number of bills dealing with DCYF and has decided to address them in SB 592. Therefore, as sections of this bill will be moved to SB 592, House Finance believes SB 582 is no longer necessary. Vote 15-10.

Original: House Clerk Cc: Committee Bill File SB 582-FN

MAJORITY REPORT

ITL

15-10

Danielson

6-4 Danielson 7 This bill makes an appropriat n of $100,000 to the Department of Health and Human Services (DHHS) to conduct a study t determine the appropriate case load for child protection staff. The appropriate caseload is alre dy known, both from national standards and a New Hampshepecific study in 2016. The bill als create/ 15 new positions in the Division for Children, Youth an Families (DCYF) ieft44-1-Faiiii-e.n and an additional $1.1 million for fund rate increases for foster care and adoption programs. Division III of the Finance committee received a number of bills dealing with DCYF and has decided to address them in SB 592. Therefore, as sections of this bill will be moved to SB 592, House Finance believes SB 582 is no longer necessary. SE 582-FN

MAJORITY REPORT

ITL

6-4

Danielson

This bill makes an appropriation of $100,000 to the Department of Health and Human Services (DHHS) to conduct a study to determine the appropriate case load for child protection staff. The bill also creates 15 new positions in the Division for Children, Youth and Families (DCYF) for $1.1 million and an additional $1.1 million for fund rate increases for foster care and adoption programs. Division III of the Finance committee received a number of bills dealing with DCYF and has decided at,z to address them in SB 592. Therefore, sections of this bill will be moved to SB 592~a 1 House Finance dosided-te Pte, SB 58

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April 11, 2018

The Minority of the Committee on Finance to which was referred SB 582-FN,

Majority, report with the recommendation that the bill

OUGHT TO PASS.

Original: House Clerk Cc: Committee Bill File FOR THE MINORITY OF THE COMMITTEE

Original: House Clerk Cc: Committee Bill File MINORITY COMMITTEE REPORT

Committee: Finance Bill=

Consent Calendar: REGULAR ecommendation: TO PASS

STATEMENT OF INTENT

This bill would allow the Commissioner to conduct an assessment to determine appropriate caseload and/ or workload standards for the department's division for children, youth and families' child protection staff that are consistent with the goals of the agency and enable them to fulfill its mission to protect children from abuse and neglect abuse. This Legislature has historically underfunded and understaffed this agency far below National standards. Currently we are running caseloads in excess of 30 per person while National standards run at the level of 12. The Majority suggests that higher staffing is forthcoming in SB 592 but is putting the proverbial cart before the horse by voting ITL on this bill first before dealing with other legislation. The minority believes we need to provide an assessment of the needs in this agency and then follows the recommendations and protect our state's families and children.

Rep. Katherine Rogers FOR THE MINORITY

Original: House Clerk Cc: Committee Bill File REGULAR CALENDAR

Finance SB 582-FN, (New Title) authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor. OUGHT TO PASS. Rep. Katherine Rogers for the Minority of Finance. This bill would allow the Commissioner to conduct an assessment to determine appropriate caseload and/ or workload standards for the department's division for children, youth and families' child protection staff that are consistent with the goals of the agency and enable them to fulfill its mission to protect children from abuse and neglect abuse. This Legislature has historically underfunded and understaffed this agency far below National standards. Currently we are running caseloads in excess of 30 per person while National standards run at the level of 12. The Majority suggests that higher staffing is forthcoming in SB 592 but is putting the proverbial cart before the horse by voting ITL on this bill first before dealing with other legislation. The minority believes we need to provide an assessment of the needs in this agency and then follows the recommendations and protect our state's families and children.

Original: House Clerk Cc: Committee Bill File SB 582-FN

MINORITY REPORT

OTP

15-10

Rogers

This Legislature has historically underfunded and understaffed this agency far below National standards. Currently we are running caseloads in excess of 30 per person while National standards run at the level of 12. The Majority suggests that higher staffing is forthcoming in SB 592 but is putting the proverbial cart before the horse by voting ITL on this bill first before dealing with other legislation. The minority believes we need to provide an assessment of the needs in this agency and then follows the recommendations and protect our state's families and children. Voting Sheets HOUSE COMMITTEE ON FINANCE

EXECUTIVE SESSION on SB 582-FN

BILL TITLE: (New Title) authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor.

' DATE: April 11, 2018

LOB ROOM: 210-211

MOTIONS: INEXPEDIENT TO LEGISLATE Moved by Rep. Danielson Seconded by Rep. Renzullo Vote: 15-10

CONSENT CALENDAR: NO

Statement of Intent: Refer to Committee Report

Respectfully submitted,

Rep Kenneth Weyler, Clerk

HOUSE COMMITTEE ON FINANCE

EXECUTIVE SESSION on SB 582-FN

DATE: LOB ROOM: 210-211

MOTION: (Please check one box)

0 OTP IS ITL 0 Retain (1St year) 0 Adoption of Amendment # El Interim Study (2nd year) (if offered)

Moved by Rep. a/citi '-4-,76"-7k7 Seconded by Rep. e It K• 4,/c) Vote: /J — 70

MOTION: (Please check one box)

❑ OTP 0 OTP/A 0 ITL 0 Retain (1st year) 0 Adoption of Amendment # 0 Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

MOTION: (Please check one box)

❑ OTP ❑ OTP/A ❑ ITL 0 Retain (1st year) 0 Adoption of Amendment # 0 Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

MOTION: (Please check one box)

0 OTP ❑ OTP/A ❑ ITL 0 Retain (1st year) 0 Adoption of Amendment # 0 Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

CONSENT CALENDAR: YES NO

Minority Report? Yes No If yes, author, Rep: Motion Respectfully submitted: Rep Kenneth Weyler, Clerk

STATE OF NEW HAMPSHIRE 1 /5/2018 10:28:56 AM OFFICE OF THE HOUSE CLERK Roll Call Committee Registers Report 2018 SESSION

FINANCE

Bill #: (15 Title: C;- )er

PH Date: / / Exec Session Date: / / 7cF— Motion: J7-4 Amendment #: MEMBER YEAS NAYS

Kurk, Neal M. Chariman / C Ober, Lynne M. Vice Chairman I Weyler, Kenneth L. Clerk 2 Allen, Mary M. 3 Umberger, Karen C. IV Twombly, Timothy L. S— Byron, Frank A. Danielson, David J. 7 Emerick, J. Tracy Spanos, Peter J. 9 Renzullo, Andrew /,' Theberge, Robert L. 1/ Bates, David M. / 2 Hennessey, Erin T. (3 Griffin, Gerald /# Wallner, Mary Jane 1 Nordgren, Sharon 2 Eaton, Daniel A. .2 Smith, Marjorie K. Rosenwald, Cindy 4/ LeishrryanT-Peter,R. 40 0.) 4, 5 Buco, Thomas L. 6- Hatetv—WilliamA3 /3 7,-- t-i e.),, 7 Rogers, Katherine D. F watti-7--Robert--14. / Zri-Q/1 9 Lovejoy, Patricia T. / 0 TOTAL VOTE: (y`-- / C)

Page: 1 of 1 Work Session Minutes HOUSE COMMITTEE ON Finance DIVISION III WORK SESSION ON SB 582-FN

DATE: April 10, 2018

ROOM: 210-211 Time Work Session Called to Order: 11:02

Time Adjourned: 11:09

Committee Members: Byron, Hennessey, Kurk, Danielson, Bates, Renzullo, Wallner, Nordgren, Rosenwald and Rogers

Bill Sponsors: Sen. Carson Sen. Avard Sen. Feltes Sen. Soucy Rep. M. McCarthy Rep. Morrison Rep. Bove Rep. Guthrie Rep. Rosenwald

TESTIMONY

Chairman Byron called the session to order at 11:02 am and stated that everything has been taken out of the bill with the exception of the study and heard testimony from the Department that there are sufficient studies already done to establish what a good caseload is and nothing is left t

Danielson motion to ITL Seconded by Renzullo

Discussion

Wallner - I am concerned about ITL concern about ITL the study it is good to say we are moving the positions over to another bill but concerned we are doing before we really had a chance to hear what is happening about what is happening in SB 592 we have a history of not funding this agency at a level that it needs to be funded historically we have not done well will doing what we need to do with our case load so moving and doing away with this before we deal with SB 592 is not wise I do have language I suggest we put into 592 when we get there

Byron - I would be swilling to accept that

Vote - Yes - Hennessey, Kurk, Danielson, Bates, Renzullo, Byron No - Wallner, Nordgren, Rosenwald, Rogers

Yes- 6 No - 4

Motion carries - ITL

Byron - recesses work session at 11:09 am

Respectfully Submitted,

Rep Katherine Rogers Clerk, Division III

HOUSE COMMITTEE ON Finance

DIVISION III WORK SESSION ON SB 582-FN

DATE: April 10, 2018 ROOM: 210-211 Time Work Session Called to Order: ifeariol

Time Adjourned:// •./

(please circle if present)

Committee Members: ordgre9 osenwa an

Bill Sponsors: Sen. Carson Sen. Avard Sen. Feltes Sen. Soucy Rep. M. McCarthy Rep. Morrison Rep. Bove Rep. Guthrie Rep. Rosenwald

TESTIMONY

Use asterisk if written testimony and/or amendments are submitted. A50 Jafiek-60 /),71/c/J .Cecene-4:-*, i6h7 2a b 2 Vas vc., e dvv- SB 582 Work Session Finance work session Div III

Apri110,2018

Authorizing an assessment to determine appropriate caseload and workload standards for the division for children youth and families ;establishing additional child protection services positions in the division for children youth and families; relative to foster care and adoption programs and services;and making appropriations therefor.

Present:Byron, Hennessey,Kurk, Danielson, Bates,Renzullo, Wallner, Nordgren, Rosenwald, Rogers

Absent

Danielson motion to ITL Seconded by Rezullo

Discussion

Byron - I would be swilling to accept that

Vote - Yes - Hennessey, Kurk, Danielson, Bates, Renzullo, Byron No - Wallner, Nordgren, Rosenwald, Rogers

Yes- 6 No - 4

Motion carries - ITL

Byron - recesses work session at 11:09 am STATE OF NEW HAMPSHIRE 1/5/2018 10:29:31 AM OFFICE OF THE HOUSE CLERK Roll Call Committee Registers Report 2018 SESSION

FIN-DIV3

Bill #: 9& 5g2-- Title: QC7/11c-Al2(1:2 Al-S-CrfC/MW 4 dtal("C"./-

PH Date: Exec Session Date: / /

Motion: //7- 60n/ "LS teriZt_ii/G Amendment #:

MEMBER YEAS NAYS

Byron, Frank A. Chariman eV Hennessey, Erin T. Vice Chairman .11 Kurk, Neal M. 'o--

Danielson, David J. Bates, David M. 6'.ey Renzullo, Andrew L0— Wallner, Mary Jane / Nordgren, Sharon '2 Rosenwald, Cindy Rogers, Katherine D. Clerk L-7/ TOTAL VOTE: 4 X

Page: 1 of 1

HOUSE COMMITTEE ON FINANCE

EXECUTIVE SESSION on SB 582-FN

DATE: ApRi\ 102-

LOB ROOM: 210-211

MOTION: (Please check one box)

O OTP pITL 0 Retain (1st year) 0 Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. f)(--06)t,s 11 /../4 Seconded by Rep. 2(-) 1 Vote: to y L.,/

MOTION: (Please check one box)

O OTP 0 OTP/A ❑ ITL 0 Retain (1st year) O Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

MOTION: (Please check one box)

O OTP 0 OTP/A 0 ITL 0 Retain (1st year) O Adoption of Amendment # O Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

MOTION: (Please check one box)

O OTP 0 OTP/A 0 ITL 0 Retain (1st year) O Adoption of Amendment # 0 Interim Study (2nd year) (if offered)

Moved by Rep. Seconded by Rep. Vote:

CONSENT CALENDAR: YES NO

Minority Report? Yes No If yes, author, Rep: Motion Work Session Minutes HOUSE COMMITTEE ON Finance

DIVISION III WORK SESSION ON SB 582-FN

DATE: April 9, 2018

ROOM: 210-211 Time Work Session Called to Order: 10:48

Time Adjourned: 11:07

(please circle if present)

Committee Members: Rogers, Nordgren, Wanner, Renzullo, Bates, Danielson, Kurk, Hennessey and Byron

Bill Sponsors: Sen. Carson Sen. Avard Sen. Feltes Sen. Soucy Rep. M. McCarthy Rep. Morrison Rep. Bove Rep. Guthrie Rep. Rosenwald

TESTIMONY

* Use asterisk if written testimony and/or amendments are submitted.

Family & Children Committee - Lewickr, Berrien,Walsh, Weber, Rice, Itse

Chairman Byron Called to order at 10:48 am

Commissioner Joseph Ribsam - Director DCYF Christine Tappan - Associate Commissioner DHHS

Byron - talk to caseload assessment we have as audit done at end of 2016 indicating caseload too high and should be brought down to 1 or so caseload per worker have studies available from other states as to what we need would it be a mistake to do this and what is Dept thoughts

Ribsam - refers to assessment portion of process we spoke about this last we assessment front end and family service longer term recommendation focused on to 12 ration and 1 to 5 on supervisor ration. Other parts of workforce also looked at at how to best use cad=se workers idea to look at complete how workforce should be looked at. You raise good point that we have other areas to look at for this work , 12 an 10 may be appropriate range look at

Bates - this may be redundant given the compromise numbers in this bill doesn't;t get even close so what is value of doing further Analysis if committee inclined to spend isn't it better to spend on staff

Ribsam - if choose where to spend money rather spend on staff but if need to make all understand what goal should be then that is value of report Wallner - who would you see doing this study

Tappan - we have various people across countries and standards applied thru out country for baseline additionally we know of organizations like state of Colorado also county based with ICF international those are both studies that offer its information we can draw upon that they identifies there was adjudication work to be done that can be taken off the caseworker's plates that can adjust the number to 10-12

Wallner - how long does it take for an assessment to be done

Tappan - around 9 days or so depending on ultimately the funding available our target was to have for budget for next year

Berrien - on line 6 page 1 you talk about the goal on=f the agency practice model would you anticipate any changes on that model with or without this study

Tappan - we don't anticipate major shifts the ability to adjust the model is the most evidence based approach that caseloads are too high

Walsh - where does trauma informed care fit in

Ribsam - solution based does fit in and ideally focused on this we have tried to push some of this out there but they are pretty expensive - it is part of the entire model and fits within how we would move forward

Kurk - if there is such a need for additional caseworker's why doesn't the Dept reallocate its staff

Tappan - I think one of the things learned across the country is they do not work as a child protection system into themselves rather then reallocating positions what we know is that when we know when we reduce the number of eligibility workers then families become even more vulnerable we are asking that you enable us to have more of a broad child ad family serving approach to allow us to meet the standards in child and family levels

Byron - am I correct at saying the Dept saying that there are resources available that say what needed as to headcount to determine what the final organizational needs are in the Department

Ribsam- what works in one state doesn't always work in another state if the goal is to know what the best structure is the study is valuable if there is as acceptance is that the 12 for assessment and 5 for supervision standards then aI am a a little more comfortable with that study

Weber - not sure this is the appropriate time for this because section 5 is now in 592 I would like to put in a huge plus for returning the section 4 positions because of the ratios we have already heard testimonies on - we need to keep the second supervisory position

Byron - one of the request of the Dept was to make a chart of the supervisory and filled people so we can get the supervisory to field people if you could bring to the work session we have on 592

Recess 11:07 am until April 10 11AM

Respectfully Submitted,

Rep Katherine Rogers Clerk, Division III HOUSE COMMITTEE ON Finance

DIVISION III WORK SESSION ON SE 582-FN

DATE: April 9, 2018 ROOM: 210-211 Time Work Session Called to Or er: W Time Adjourned:

F 1 (please circle if present)

Committee Members: , Daniels , Re nzula,Ealkier,- Nordgre , Rosenwal

Bill Sponsors: Sen. Carson Sen. Avard Sen. Feltes Sen. Soucy Rep. M. McCarthy Rep. Morrison Rep. Bove Rep. Guthrie Rep. Rosenwald

TESTIMONY

Use asterisk if written testimony and/or amendments are submitted.

((in'i Pcc-tr..s ut-N iqpkA CD SB 582

Work Session Div III April 9, 2018

Present: Byron, Hennessey, Kurk, Danielson, Bates, Renzullo, Wallner, Nordgren, Rogers,

Absent:Rosenwald

Family & Children Committee - Lewickr, Berrien,Walsh, Weber, Rice, Itse

Chairman Byron Called to order at 10:48 am

Commissioner Joseph Ribsam - Director DCYF Christine Tappan - Associate Commissioner DHHS

Ribsam - if choose where to spend money rather spend on staff but if need to make all understand what goal should be then that is value of report

Wallner - who would you see doing this study

Wallner - how long does it take for an assessment to be done

Tappan - around 9 days or so depending on ultimately the funding available our target was to have for budget for next year

Berrien - on line 6 page 1 you talk about the goal on=f the agency practice model would you anticipate any changes on that model with or without this study

Tappan - we don't anticipate major shifts the ability to adjust the model is the most evidence based approach that caseloads are too high 416 Walsh - where does trauma informed care fit in

Ribsam - solution based does fit in and ideally focused on this we have tried to push sort) o)f. this out there but they are pretty expensive - it is part of the entire model and fits within ho'we would move forward

Kurk - if there is such a need for additional caseworker's why doesn't the Dept reallocate its staff

Byron - am I correct at saying the Dept saying that there are resources available that say what needed as to headcount to determine what the final organizational needs are in the Department

Byron - one of the request of the Dept was to make a chart of the supervisory and filled people so we can get the supervisory to field people if you could bring to the work session we have on 592

Recess 11:07 am until April 10 11AM Hearing Minutes HOUSE COMMITTEE ON FINANCE

PUBLIC HEARING ON SB 582-FN

DATE: April 3, 2018

LOB ROOM: 210-211 Time Public Hearing Called to Order: 1:00

Time Adjourned: 2:33

Committee Members-: Reps. Kurk, L. Ober, Weyler, Allen, Umberger, Twombly, Byron, Danielson, Emerick, Spanos, Theberge, Bates, Hennessey, G. Griffin, Wallner, Nordgren, Eaton, M. Smith, Rosenwald, Leishman, Buco, Hatch, Rogers and Lovejoy

Bill Sponsors: Sen. Carson Sen. Avard Sen. Feltes Sen. Soucy Rep. M. McCarthy Rep. Morrison Rep. Bove Rep. Guthrie Rep. Rosenwald

TESTIMONY

Sen Carson Introduced the bill. Chair Kurk introduced the Children and Family Law Committee for this joint hearing.

Sen Carson- Several additions have been made in other committees. Originally was to establish case loads as a result of a study committee from 2 years ago. Sixty cases each vs. 12 for national average. Others will comment on changes.

Jos. Ribsam, DCYF Director of 5 months, served 10 years in NJ, we 9600 Child Protective Workers. We reformed from 30 to 12 cases per in NH August is 42 per down from 90 per. Foster care doubled in last 3 years. It originally required adding 90 staff. This calls for analysis. Second part is adding supervisors. Need new staff, more supervision, 5 to 1. Last part to add to rate for Foster Care.

(Q) Itse- Why need for supervisors? (A) Training (Q) Ober- We deal with Finance? (A)Analysis study (Q) Ober-Timing? (A) January next year, out to bid. (Q) Ober- Case workers doing clerical, will you be adding clerks? (A) Not included yet. Not a hard time hiring people, a hard time keeping people. (Q) Kurk- Vacancy? (A) 119/125 89/92 Family services

Foster Care Rates, lower than most states, discourages relatives from taking training, for licenses TANF rate higher than foster care. So why get the license?

(Q) Ober- with all these uncertainties how did you arrive at FN? (A) Leadership (Q) Kurk- Where will the money come from? (A) I don't know?? (Q)Leishman- Foster Care has doubled? Why? (A) A whole host of reasons, opioid, lack of capacity, very expensive. mainly react to abuse and neglect. (Q) Smith- You said leadership, which? House, Senate, Governor? (A) Not sure (Q) Smith- They have been very busy at reducing funds. Not in on conversation (Q) Hennessey- TANF to take care of grandchildren, is that Federal? If they are getting TANF can they train for Foster care? (A) Not financially viable. (Q) Berrien- Also on family care side, are we working on that? (A) Later, right now great need on assessment vs. family service. (Q) Weber- Respect to back log is because attention on most dire? (A) Yes, triage. (Q) Itse- Foster care low relative to VT and ME? (A) I don't have figures, (Q) Unlicensed grandparents can get only TANF. If they are licensed what can they get? (A) Both state and federal money. (Q) Itse- Affect on state? (A) depends on services

Amelia Hogan- My opinion; I have worked in office for 2 years. Day to day. We must be in contact with client every month, 2 hour visit, 72 hours /month. Court report 120 hours/year, not including other study. Less than one week/month for all other requirements. Meetings, drug tests terminating parental rights at an unprecedented rates. PTSD, among us, no time off. Bill was transformed. We don't need a study. (Q) Berrien- numbers of cases? 10-12 highest carried was 22 now 19 + 4 assessment; never under 16 cases. (Q) Long- Prefer social work? (A) Yes (Q) Spanos- Can some better manage? (A) Yes (Q) Spanos Is this disparity due to experience?

Dolly McPhaul, DCYF Advisory Board, My own opinion, You are responsible, Understaffed Under funded. (Q) Smith Are any of your groups to speak out to general public for more revenue? Moira O'neill, Office of Child Advocate- I don't know where money comes from but with out more staff its only going to get worse. I investigated child services, we used to have volunteers, I support all 3 bills. Need parenting skills, coping, too much toxic stress, development effect.

Keith Kuenning, Advocacy Director, All these bills speak to resources. From 1100 a month e no get 5,000 in 3 months. Foster families are underpaid- 50% turnover in 2 years. You have not been told enough in the past. (Q) Kurk- These are band aids, what cause? Opioid crisis. These 3 are more than band aids. (Q) RogersWhat's in the next budget? (A) $16 dollars a day is not enough, $20 (Q) Weber- Most effective is family support, which we lack? (A) Yes, upstream more voluntary services. (Q) Berrien- Some abuse and neglect has decreased nationally, why does ours increase? (A) We have reported it OK when it wasn't.

Adam Steele, Foster parent, school district several committees, we support bills as a result of what our team recommended. Prevention services overlooked being reactive to crises. Volunteer services lack, "upstream" to prevent more expensive services.

Laurie Pellitier, SEA formerly CPS started as family services worker after 16 years burned out. Earlier Directors failed to ask. (Q) Itse- When did you have to leave? (A) Went out on FMLA (Q) Hatch- How do you do it? DCYF responsibility but we are all responsible (Q) Mulligan- I keep hearing we were not aware, how come? (A) Not right person

Richard Gulla- Brian Hawkings instead. We have been working on this for years. Long process for union to show concern? We have been working with committee

Blue sheet- No opposition

2:33

Respectfully Submitted,

Rep Kenneth Weyler, Clerk HOUSE COMMITTEE ON FINANCE

PUBLIC HEARING ON SB 582-FN

ROOM: 210-211 Time Public Hearing Called to Order: 11`0

Time Adjourned:

(please circle if present)

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Bill Sponsors: Sen. Carson Sen. Avard Sen. Feltes Sen. Soucy Rep. M. McCarthy Rep. Morrison Rep. Bove Rep. Guthrie Rep. Rosenwald

TESTIMONY

* Use asterisk if written testimony and/or amendrzne is ar submi d. /I

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SENATE BILL 582-FN, AN ACT, authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor.

TESTIMONY BY:

Sen. Sharon Carson Pg. 2 Joseph Ribsam Pg. 4 Amelia Hogan Pg. 22 Dolly McPhaul Pg. 28 Moira O'Neill Pg. 30 Keith Keunning Pg. 33 Adam Steel Pg. 39 Laurie Pelletier Pg. 41

(The public hearing convened at 1:02 p.m.)

NEAL KURK, State Representative, Hillsborough County, District #02 and Chairman: Good afternoon. Like to welcome all of you to the House Finance Committee and this afternoon's public hearings. Again, if you wish to testify, please fill out a pink card and make sure it's passed up to the head of the table. If you wish to express support or opposition but not speak, please fill out one of the blue forms on the table.

If you have testimony, written testimony that you're going to wish to have distributed, please make sure that is given to Mr. Ripple to my left by the wall. He will three- hole punch it and distribute it after the session is over so that every member of the Committee will, in fact, receive a copy. 2

For the first three bills we welcome the following members from the Children and Family Law Committee. The Chair, Representative Kim Rice, the Vice-Chair Representative Dan Itse, and then Representatives Spencer, Berrien, Weber, Walz, Mulligan, Scully, Long and Lewicke. They will be fully participating in today's public hearing and in work sessions at the Division level.

And, with that, I'd like to call upon Senator Carson to introduce Senate Bill 582-FN authorizing an assessment to determine appropriate caseload and workload standards for the Division For Children, Youth, and Families; establishing additional child protection services positions in the Division For Children, Youth and Families; relative to foster care and adoption programs and services; and making appropriations therefor.

Good afternoon, Senator, and welcome to the House Finance Committee.

SHARON CARSON, State Senator, Senate District #14: Good afternoon, Mr. Chairman, and good afternoon, Madam Chairman.

For the record, my name is Sharon Carson, and I have the pleasure of representing Senate District 14 comprising the towns of Londonderry, Hudson, and Auburn. And I have this afternoon for your consideration Senate Bill 582-FN which originally started out as relative to caseload standards for child protection service workers in the Department of Health and Human Services but has since had some additional language put into it.

So I'd like to speak about to what I filed because, again, this went to Senate HHS where the language concerning foster families and other things that were added to that, and there are folks that can speak to that. But this bill establishes caseload standards for child protective service workers in the Department of Health and Human Services. It also established a quarterly reporting requirement and procedure for funding additional case workers in the event that the caseload limitations were exceeded. HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 3

Mr. Chairman, this comes directly from the independent study that was done I think almost two -- be close to two years ago, I think, where they identified one of the biggest problems that we had was the fact that our caseload workers were horribly overstressed with the number of cases that they were carrying. I believe at the time it was mentioned that the national standard is 12 and some of our caseload workers were carrying well over 60 cases. And that, in part, led to a huge backlog of cases. And, again, that led to another situation where I believe over 1500 cases were just summarily dismissed. And then we had to have someone come in to look at those cases to make sure that they were done properly.

So what this really wants to do is to really set caseload standards so that any time anyone that goes to work for the State of New Hampshire as a caseload worker, they have some sort of an idea how many cases that they can hold or be working on at any one particular time. We want to make sure that every case that gets presented to DCYF is thoroughly examined; and if you're carrying a very large number of cases, there really is the presumption that you just don't have the time to put into each case that needs to happen. Plus, sometimes these case workers get pulled off because there's an emergency that's happened and they have addressed that.

But, Mr. Chairman, that is the genesis of the bill, as I filed it. Again, it's been expanded to include others, and there are people here that have been very involved with making changes within the Senate version, which is what you have in front of you now. I will at this point conclude my testimony, and I'm not sure if I can answer questions but I'll try.

CHAIRMAN KURK: Thank you, Senator. Are there questions? We will have somebody from the Department who is -- who will be testifying next so if we have technical questions we can save them. Thank you, Senator.

SEN . CARSON: Thank you very much, Mr. Chairman, Madam Chair. HOUSE FINANCE COMMITTEE April 3, 2018 SENATE BILL 582-FN 4

CHAIRMAN KURK: Chair recognizes Joseph Ribsam representing DCYF. Good afternoon, sir, and welcome to House Finance.

JOSEPH RIBSAM, Director, Division of Children, Youth, and .Families, Department of Health and Human Services: Good afternoon. Thank you, Chair. Thank you, Madam Chair. Thank you, Committee Members of this very large panel. I haven't had the chance to meet many of you in this room yet. I have been before Children and Family Law a number of times but have not been before the Finance Committee. So I'm going to briefly introduce myself.

My name is Joseph Ribsam. I'm the fairly new Division Director for the Division of Children, Youth and Families. I've been here for just over five months at this point. I come here after serving for the past nearly ten years in the State of New Jersey in their child protection system.

Their system's structured a little bit differently than here. It was the Department of Children and Families scooped out of a broader health and human services agency. We were responsible for child protection. We were responsible for services to young people under the age of 21 for behavioral health, developmental and mental disabilities, substance use disorder; also responsible for sexual violence and domestic violence services. It was a Department of 6600 total staff with a $1.8 billion budget. We had 3600 frontline child protection workers.

Mind you, New Jersey is population-wise about nine times the size of New Hampshire so that accounts for some of these discrepancies. But when we started New Jersey we were seen as one of the worse child welfare systems in the country. And when New Jersey, you know, in the past few years has been seen as really a model across the country.

When we started we had a situation that looked much like what we have today with caseloads that were well out of control, with 12,500 kids in foster care, and with the service array that HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-EN 5 really didn't meet the needs of our kids and families. And when -- within the past few years we have been in a position where we have the number of kids in foster care under 6300 from that 12,500. Where there's an average caseload of about 12 per worker as opposed to the, you know, 30 plus that we had back then. And where we had the service rates that really met the needs of our kids and families to keep kids safe at home, which is really the goal of the child protection agency is to keep kids safe at home.

When I came here there was a lot that I saw that we needed to pay attention to. I mean, fundamentally, the child protection system in the state remains disregulated. We're in a state where we have caseloads which are really unbearable. Where we have staff who, as I said before, the national standard is comparable to 12, somewhere in that range. We have average caseloads and assessment of 42 right now. The -- and that's actually a huge improvement.

In January 2016, the average caseload was over 90. So we see a lot of progress, but we have a long way to go in this measure. And caseloads are an important thing. If you expect case workers to be able to spend time with families to keep kids safe at home, that requires them to actually engage in real social work with families; to sit down with them, identify the natural supports in their communities, grandparents, aunts and uncles, neighbors, church members, other faith-based members, these types of folks who can come in and kind of support the family and keep the family strong to keep that family together. When you don't have that type of system, you end up seeing what we see here right now which is a foster care system which is doubled in the past three years. We have twice as many kids in foster care today as we did three years ago.

That's a real, real problem. It's a problem for our kids. It's a problem for the system. It's a problem for the state. We have a foster care system that we don't have enough homes to support the number of kids that we are bringing in anymore. So you have enhanced reliance on residential care which is a very, very expensive intervention. Foster care itself is a very, very HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 6 expensive intervention, much more so than actually doing the work of keeping kids safe at home in the first place.

So this bill, and really all three of the bills that we're going to talk about today, do an awful lot to step towards remedying these problems. And I think it's just a step. It's not a solution. But it goes an awful long way towards helping all of these problems.

This particular bill started off, as Senator Carson said, as a caseload standard bill, was going to create a standard of 12 for our assessment workers and for ten for family service workers. The fiscal analysis that came along with that would have required a hiring of 90 staff to accomplish those -- those caseloads. I think the analysis that went along with that around where we were fiscally right now and what could be politically and economically achieved in the current climate was that that was probably more than was available right now. So, instead, the approach that's been proposed in the Senate Bill is to conduct a formal workload analysis to figure out what an actual reasonable work standard is for our staff, and the type of staffing that office deserves and needs. And that doesn't just mean case workers. That could be, you know, there's probably functions -- I know there are functions that our case workers are handling right now that are better handled by lower paid staff, right, clerical staff, people doing transportation, things like that. And when you have that type of work in the mix then the caseload could be a little bit higher. So the workload analysis would help us figure out the answers to those questions.

The national standards that are cited really don't apply perfectly to any one child welfare system because every system is so different. You know, in New Jersey we served many, many more kids at much less risk, right? You have a child at lower risk, you have a less intense family, you can carry more cases because it requires less attention. If you have very, very high risk kids, those are more intense families, they require more attention. You can't carry as many cases. So you really can't

HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 7

compare these caseload standards across. The first part of the bill will address that.

The second part of the bill is to hire 13 CPSWs to start making the progress towards what's needed to bring caseloads into a reasonable amount and two more supervisors. Supervisors are critical, especially at a point where we are today in our child welfare system. If you expect staff that we hire, which are largely newer staff at this point, because we're building up a system that has had an awful lot of turnover in recent years, if you expect them to engage in quality work with families, they need to have strong supervision from supervisors who know what they're doing. And that means you have to get close to what those national ratios are for supervision which is about five workers to one supervisor. We're not at a ratio like that today. But, also, if you increased the number of case workers, of course, there'd be an increased need for supervisors.

The last part of this bill was an add-on. I'm not exactly sure the genesis of it, but there were lots of conversations in our foster care subcommittee, the Joint Committee around what the rate is, the subsidy rate for foster care, what the subsidy rate is for adoption, and what the services are to support foster families and adopted families. That's what the last piece of this bill does. The last piece of the bill puts more money into that system so that we can adjust the rate and looks for ways to better support our foster parents. And, with that, I'm happy to pause and take questions.

CHAIRMAN KURK: Thank you very much. Representative Itse.

DANIEL ITSE, State Representative, Rockingham County, District #10: Thank you, Mr. Chairman. You mentioned that currently we're at 42. The kind of objective out there is 12. Be better defined on that in the future. With the addition of the 13, can you tell us what the nominal number will be for caseloads?

MR. RIBSAM: It's hard to get you an exact number. I think what, you know, we're seeing right now caseloads are dropping HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN for two reasons. One, because we're having -- we have an intensive effort to close the overdue in backlogs. Those feed into the caseload number which makes the caseload number pretty murky right now.

The other thing that's happening is it takes time to train up staff, right? So when you hire somebody it's really six months before they can carry a full caseload, unless there's somebody coming in with experience from another child protection agency. There's a long period of time to train people up. So we are seeing caseloads dropping because some of the folks we hired after the additional increase of last year are finally coming on board now and that's feeding into the reducing caseload numbers.

I would expect that we could probably get into the thirties as a caseload, probably maybe into the low thirties. I'm hesitant with that because there's a lot of variables; but I think with 13 additional staff that's reasonable where we could get. So there's going to still be work to do.

CHAIRMAN KURK: Representative Ober.

LYNNE OBER, State Representative, Hillsborough County, District #37: Thank you. Thank you for coming to Finance. It's nice to meet you. This is primarily a Finance Committee and we're dealing with the appropriation.

MR. RIBSAM: Hm-hum.

REP. OBER: Very little of your testimony dealt with the appropriation or what you would be doing with said appropriation, which is leaving us with a lot of questions. So I would like you to give us detail of all three of those appropriations.

MR. RIBSAM: Sure.

REP. OBER: Let's start with the hundred thousand dollars to create the needs assessment. How will that be spent? What is

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SENATE BILL 582-FN 9

the timeline for spending that? What are the expected outcomes? Have you written measurable outcomes for spending that money?

MR. RIBSAM: So the -- the goal with that would be to procure for tested expert analysis conducted to figure out the workload study. There have been comparable studies produced in other child welfare jurisdictions. I've spoken to folks in Colorado that have done this as well. Their system's different because the county pays so they had to produce a separate one for each county. But through those conversations were we came to what would be a reasonable number to be able to put out for appropriation to conduct this study.

The goal would be to have them be able to look at the child welfare caseloads but also kind of the entire workforce mix to give us good recommendations as to what is a reasonable expectation of what staff can do in a given amount of time and, therefore, the amount of caseloads that's appropriate; but also to look at what other types of resources need to be involved just to make sure people are working efficiently, and you have the lowest paid staff doing the appropriate work, right? So you don't have case workers making copies, but rather you have clerical staff who make copies and case workers can spend their time engaging in families.

CHAIRMAN KURK: Follow-up.

REP. OBER: There's two pieces of that question that you didn't address. One, who is them, and what is the timing for this expenditure?

MR. RIBSAM: The timing is set forth in the bill to be completed by January of next year. So January of '19. The -- them would be who we procure with. So I don't know the answer to that until we put that out to bid.

REP. OBER: Second question, Mr. Chairman. I'm looking at the next appropriation which is $1.1 million and starts on Line 22 --

HOUSE FINANCE COMMITTEE April 3,2018

SENATE BILL 582-FN 10

MR. RIBSAM: Hm-hum.

REP. OBER: -- of the bill. Part of your testimony was, and I know it's true, you have case workers doing a lot of clerical things, especially arranging transportation for kids in your services. We see 15 positions here, none of them clerical. So we'll just be having 15 more professional people doing clerical work. How -- what is the breakdown for that million dollars of how you expect to be allocating that among the positions you have? And when do you expect to actually hire? Like will you have to space that over six months? How available are these people and are they in place which you probably know by now?

MR. RIBSAM: So it is true that this is for professional staff and not clerical staff. I think given where we are right now as a system with the caseloads we have that's the right focus point; but I do hope that what we'll see out of the workload study is a better understanding what the rest of the office milieu should be.

The way that the funding is broken out here, and I believe there is an updated Fiscal Note that if it's not here yet it will be here soon, which breaks down the federal and the state funding more clearly than the version of the bill that went through Senate Finance in the past couple weeks. So the breakdown for the positions is 604,000 in General Funds to cover the 13 child protection workers and two supervisors, 370,000 in Federal funds. That's with matching dollars through what's called a Title IV-D under the Social Security Act.

The hiring question. We're not having a hard time hiring people. We are having a hard time keeping people and that was true in New Jersey as well when we started. We had to hire, you know, well over a thousand staff a year for three years in a row to get the system right sized. And a lot of people right now we have turnover rates that are close to 30% in child protection. The only way to get to the other side of that is to start bringing people into the system and start stabilizing the system. Until staff feel like they have a job that they can accomplish and be successful with, it's going to be very hard to HOUSE FINANCE COMMITTEE April 3,2018

SENATE BILL 582-FN 11

keep them. So this is a step towards getting there, but it's certainly not going to be the solution.

CHAIRMAN KURK: Did I understand you to say you have no trouble hiring people in an economy with a 2.6% unemployment rate?

MR. RIBSAM: We have been able to fill the positions that we've been given, but we have been losing people. That's the challenge.

CHAIRMAN KURK: How many positions that you're currently authorized to have in this area are vacant?

MR. RIBSAM: Right now --

CHAIRMAN KURK: Of the total.

MR. RIBSAM: Right now there are a total of 125 assessment workers, 119 are filled; but there's a constant churn, right? So people leave, new people come on. Right now for Family Service, which is the back end of the system, we have 92 positions. We have 89 filled. Again, there's always this churn because of the turnover. But we are really not having trouble hiring people. We are having trouble keeping them.

CHAIRMAN KURK: Thank you.

REP. OBER: Okay.

CHAIRMAN KURK: Further question from Representative Ober.

REP. OBER: The final piece, the 1.1 million for foster care, can you just do for that what you've just done for the past one?

MR. RIBSAM: Certainly. The idea there is to -- and I don't have an exact number as to what we're going to do with those rates yet, because there's someone else, you know, to how this is going to impact other parts of the system. So breakout of the HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 12

foster care rates that we pay in this state are significantly less than what many other states pay, significantly less than the cost of raising a child. That's a problem for a number of reasons. It makes it hard to recruit and keep foster parents. It also makes it difficult to encourage relatives to get licensed as foster parents, which is really the best practice when you're talking about -- when you're placing a child with a relative, ideally you want to have that relative be licensed, because then they get the added training, the added support, and that kind of added measure of security around that placement. It also then opens up that placement to start receiving federal reimbursement. If you have a child in an unlicensed placement, you get no federal match for that placement.

Right now the TANF rate that relatives receive if they care for -- if a grandmother takes in a grandchild is higher than the foster care subsidy rate. So our financial incentives are backwards. We incentivize families to not be licensed. So the goal would be to raise -- make sure that the foster care rate gets raised to the point where it exceeds the TANF rate so you actually have your financial incentives lined up with your best practice and your policy. And to raise it to a point where it's not going to -- the amount of money here is not going to get the foster care rate to the actual cost of raising a child in the State of New Hampshire according to USDA guidelines. That's how New Jersey set our foster care rates. We looked at the standard and set them accordingly. It's going to push us, I'd say, maybe close to three-quarters of the way there which is going to be substantial.

The other part that's a little bit of a variable that we are still figuring out which is going to impact what the total rate change is going to be is that changes that are made on the foster care side are being impactful on the adoption subsidy side. I haven't been able to totally work out that analysis yet to tell you exactly what that number is going to be. We have to think about all those things in concert.

REP. OBER: Last question. If you haven't worked that out, then how did you arrive at this figure that's in the bill? HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 13

MR. RIBSAM: It was a conversation that was had, you know, between -- between leadership given what the -- what was seen to be, you know, realistically available economically and politically right now. So it's a good number that I think is going to get us to about 75% of what we -- what would be the USDA rate for raising a child in the State of New Hampshire. But, you know, there's a practical reality to how that number was set. It wasn't -- it wasn't just the, you know, the dream of what I would hope to pay and then having an amount put in there to do that.

REP. OBER: Thank you.

CHAIRMAN KURK: Would you -- you're welcome. Would you care to tell us where this money is coming from? Our budget is over and we've only budgeted a surplus of $600,000.

MR. RIBSAM: You know, it's -- that's a question that I -- that I have not been privy to those conversations. Those are conversations that happened, you know, between legislative leadership and the Governor's Office and other folks. So I assume there's a plan for that, but I do not know what the plan for that is.

CHAIRMAN KURK: When you do find out, would you share it with us? Representative Leishman.

PETER LEISHMAN, State Representative, Hillsborough County, District #24: Thank you, Mr. Chairman. Thank you for your testimony. During your testimony you mentioned that the foster care has increased as far as the people needing that foster care by double?

MR. RIBSAM: That's correct.

REP. LEISHMAN: Is that due to the lack of financial incentives or are there other reasons?

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SENATE BILL 582-FN 14

MR. RIBSAM: There's lots and lots of reasons. You know, what you see in -- so, I mean, there's a host of reasons. I think one thing that people cite, which I believe is true, is the opioid crisis, right? So I think there's an actual genuine increased need. The counter point that I would make to that is that New Jersey had an opioid crisis, too. Our opioid crisis started right after Super Storm Sandy. Neither of those things caused our foster care system to blow-up the way it has here.

The difference is that in New Jersey the system was big enough and broad enough and had the support to actually work with families to keep kids safe at home. What's happened here instead is the system didn't have the capacity to respond in that way. And instead of doing that hard work of keeping kids safe at home in the first place, kids ended up coming into care. That's a bad thing for the kids. It's a bad things for the families. It's a bad things for the State Budget. Bringing kids into foster case is the most expensive intervention we have. So if you want to save money, you have to make sure that you're doing what you can to keep kids safe at home.

The system in New Hampshire is currently designed to literally react to abuse and neglect. So if we go out there on day one and we see that a kid's at risk, the only choices we have are we remove or we craft up a safety -- a safety plan on paper which, you know, isn't the best protection. There's no ability on that day one to actually put services in place to keep those kids safe.

In most jurisdictions that's -- that's common and normal practice that when you go out on day one you do what you can to keep the kids safe at home. So this bill isn't addressing that specific issue, but I think that is one of the main issues -- one of the main reasons why we have a system today that's really blown up on the foster care side. And some of the other bills we're going to talk about do get into those specific issues.

REP. LEISHMAN: Thank you. Thank you, Mr. Chairman.

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SENATE BILL 582-FN 15

CHAIRMAN KURK: Representative Smith.

MARJORIE SMITH, State Representative, Strafford County, District #06: Thank you, Mr. Chairman. Hum -- I'm buried back here.

MR. RIBSAM: I see you.

REP. SMITH: Welcome.

MR. RIBSAM: Thank you.

REP. SMITH: And I imagine we'll see a lot more of you. When you spoke you referred to leadership made a decision. Can you tell me what leadership that is?

MR. RIBSAM: So I wasn't privy to all those conversations; but my understanding was that you had legislative leadership in the Senate, you had, you know, leadership within the Department and you had the Governor's Office.

REP. SMITH: Thank you very much.

CHAIRMAN KURK: Did I hear you mention the House?

REP. OBER: No, you didn't.

MR. RIBSAM: I do not know. I wasn't part of all the conversations as I said.

CHAIRMAN KURK: Thank you.

REP. SMITH: Could I follow-up?

CHAIRMAN KURK: Please.

REP. SMITH: Thank you very much for clarification. And I know you weren't-in the meeting, but perhaps someone was kind enough to share with you where the -- the Senate leadership and the Governor planned to find the money because they have been HOUSE FINANCE COMMITTEE ApriI3,2018 SENATE BILL 582-FN 16 very, very busy this year trying to through tax avoidance approaches primarily, but other approaches, trying to cut down significantly on the funds available to -- for the State Budget. So on the one hand they are taking away, and on the other hand they are recognizing the severe lack of funding. And did they challenge anyone, perhaps in the Department, perhaps elsewhere, to figure out how to manage to walk down two divergent paths at the same time?

MR. RIBSAM: I -- again, I really can't answer because I wasn't privy to the meetings. What I would tell you is that the problems we have right now within DCYF are not going to get any less expensive through inaction. They're going to get more expensive through inaction. The only way to actually change the financial trajectory of DCYF is to start doing the work to keep kids safe at home in the first place. And the only way to do that is to properly resource that end of the system.

REP. SMITH: Thank you. I couldn't agree with you more.

CHAIRMAN KURK: Chair recognizes Representative Hennessey.

ERIN HENNESSEY, State Representative, Grafton County, District #01: Thank you, Mr. Chairman. Thanks for taking my question. You had mentioned that some people receive TAFN funds to take care of -- is it grandchildren?

MR. RIBSAM: That's correct.

REP. HENNESSEY: Follow-up.

CHAIRMAN KURK: Follow-up.

REP. HENNESSEY: Are the TANF funds fully Federal funds these people are receiving?

MR. RIBSAM: Yes, that's correct.

CHAIRMAN KURK: Follow-up.

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SENATE BILL 582-FN 17

REP. HENNESSEY: If one is trained to be a foster parent, can they still receive TANF funds?

MR. RIBSAM: It is -- it's possible, but if they're not licensed they can't be claimed on federal IV-D which is the federal Social Security Act which pays federal dollars for foster care. So you have to go through that licensure process with them. And, really, the way that people engage in that process is because of the financial outcome on the other side, right? So when you have a system which is designed to -- to reimburse the inaction over the preferred action then, you know, people are going to make the choice to not be licensed and go through that extra effort.

REP. HENNESSEY: Thank you.

CHAIRMAN KURK: Representative Lewicke.

JOHN LEWICKE, State Representative, Hillsborough County, District #26: Thank you, Mr. Chair. Thank you for taking my question. One of the things I've seen in your testimony in the DCYF report from December of 2016 was a large paperwork backlog. And that basically in the DCYF report that cases not close and that appeared to be -- had not yet been punted into the computer system for paper records. Can you give us an idea of what the caseload would look like if you basically subtracted out that paperwork backlog?

MR. RIBSAM: I haven't done that math, so I can't tell you. But I'll speak a little bit to the backlog, if you don't mind. The backlog, and I've shared this data in other forms. Unfortunately, I don't have it here, but I'm happy to share it with folks who are interested. The backlog at one point was up to 3500 overdue assessments. In a system like ours that's really a problem, not just because of the fact that they are overdue, and therefore, you know, the analysis -- I'm sorry. Not just because of the fact they're overdue but also because in a system like ours we don't actually intervene until we finish that assessment. If you have a system like many states do where you intervene on day one to keep kids safe, then the overdue HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 18 assessment isn't quite as consequential as it is for a system like ours which is reactive to the assessment.

The assessment backlog today is down to around 1900 as opposed to the 3500 that it was, which I think is a big part of why you see those caseloads coming down and at the same time the additional staff coming on board, those two things converging to bring that down. We have a new effort underway right now under contract with Child and Family Services who are helping us to go through those overdue assessments and identify kind of where the T's need to be crossed and the I's need to be dotted so that our supervisors can do a final review to close those cases. So I do expect those numbers are going to continue to drop. That's a newer process that's only started in the past two months maybe. So I do expect we're going to continue to see that number decline.

I do want to caution that child welfare system never actually gets to zero on that number because there are many instances where it wouldn't be appropriate to have an assessment completed within the timeframe. That would be where you have, you know, law enforcement and prosecutorial action happening at the same time which is causing our investigatory function to take a back seat, where we have particularly complex medical situations or particularly complex psychological situations that require some enhanced review from those experts which is taking longer to complete. But that current number of 1900 is certainly way too high and I would expect that number to be, you know, New Jersey we tried to maintain no more than about 10% of our cases were over a 60-day threshold and that seemed to be a pretty fair way to think about it.

REP. LEWICKE: Thank you.

CHAIRMAN KURK: I'm sorry, I don't know your name.

SKIP BERRIEN, State Representative, Rockingham County, District #18: Representative Berrien.

CHAIRMAN KURK: Berrien, thank you. HOUSE FINANCE COMMITTEE April 3,2018

SENATE BILL 582-FN 19

REP. BERRIEN: Thank you. All right. You have mentioned that there will be 13 new -- you're proposing 13 new child protection workers coming on. In the report that we had in December of '16, it focused almost exclusively on the assessment side of it.

MR. RIBSAM: Hm-hum.

REP. BERRIEN: Is there a sense that some of these 13 new CPS workers would be also on the family service side? Give us some comments on the needs on that side.

MR. RIBSAM: Absolutely. I mean, the needs are on both sides. The Fiscal Note that was done for the original 582 had numbers -- had recommendations on both sides of the assessment side and the family service side of the system. We have some -- I've already compiled some data about where the greatest needs are and there's great needs in both assessment and family service. So I would guess we probably put -- I don't want to be held to this but probably be slightly less than half going to family service and the balance going into assessment.

When you think about child welfare work, you know, it's not the prettiest metaphor, you think about a snake eating something, right? And the assessment part of the system has been overwhelmed for so long and family service side of the system at that moment back in 2016 was pretty stable. And now that those cases have kind of moved through the system, the family service side of the system is just as destabilized as the assessment side of the system is. And, unfortunately, we are not seeing any evidence in the data that the assessment side of the system is slowing down. In fact, January of 2018 was a record high for new referrals or new screened assessments. In January '18, February of '18 was a record high. I haven't seen the data yet for March of '18 but, you know, the trending has been that every month is the highest month that we've ever had.

CHAIRMAN KURK: Thank you. Representative Weber.

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LUCY WEBER, State Representative, Cheshire County, District #01: Thank you, Mr. Chairman, and thank you, Director. Am right in thinking with respect to that backlog, part of the reason that the backlog built up to horrendous levels is that if you have a system in crisis you turn your attention to the case that is the most dire. And then the ones that are not as dire tend to be shifted to the back burner. And it's those cases, for the most part, that we're working through. But that if we transition over time to a -- to a front-loaded let's get the system -- the services to families while they're still intact, that not only will it take care of the backlog stuff, but we won't be getting into this kind of critical situation because people will get the services they need before it gets critical and it's better for the kids and the family.

MR. RIBSAM: That's all absolutely right. The, you know, our workers on a daily basis are triaging their interactions with family as opposed to really engaging in social work. And operating in that environment, people are going to make quick decisions about where they think the highest risk is, which may or may not always be correct. People are making split decisions. They're not always the best decision. And then folks feel accountable for the outcomes of those decisions. I strongly believe that systems produce the outcomes that those produce. You know, the outcomes we're seeing are the outcomes our system is currently built to produce.

CHAIRMAN KURK: Thank you. The last question goes to Representative Itse.

REP. ITSE: Thank you, Mr. Chairman.

CHAIRMAN KURK: Excuse me, the next to last question. Representative Long has a question.

REP. ITSE: Still thank you, Mr. Chairman. You mentioned that our foster care rates are below many other states. Most relevant are the states that are most similar to us demographically and geographically. Can you place our foster care rate relative to, say, Vermont and Maine? HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 21

MR. RIBSAM: Off the top of my head I can't; but I can certainly get that information and share it.

CHAIRMAN KURK: Follow-up.

REP. ITSE: Thank you, Mr. Chairman. Still trying to understand the TANF licensing issue.

MR. RIBSAM: Hm-hum.

REP. ITSE: If I understand correctly, unlicensed grandparents, say, are only eligible for TANF funds?

MR. RIBSAM: If they're not licensed, that's correct.

REP. ITSE: And those are Federal funds?

MR. RIBSAM: Those are federal block grant TANF funds, yes.

CHAIRMAN KURK: Follow-up.

REP. ITSE: If they become licensed, what are they eligible for?

MR. RIBSAM: They're then eligible for actually either. They could eligible for the TANF funds or they could be eligible for the foster care subsidy which is backed by federal IV-E -- by Title IV-E of the Social Security Act. The nice thing about Title IV-E is unlike TANF, which is a block grant, Title IV-E is a federal entitlement meaning that the pie continues to grow as you have more services come in.

The other piece of that that's really important is that it's not just the subsidy, but it's all the services to the child who's in foster care which can then be reimbursed federally. You lose that opportunity if you don't have licensed foster parents.

CHAIRMAN KURK: Follow-up. HOUSE FINANCE COMMITTEE April 3, 2018

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REP. ITSE: Thank you, Mr. Chairman. If we get licensed for or either licensed or unlicensed, does it change the proportion that the State is paying?

MR. RIBSAM: If you have a greater proportion of foster parents who are receiving a foster care subsidy, there will be a greater portion that the State has to pay. That's part of the complication of figuring out what the rates are going, what the rates could be with the resources.

CHAIRMAN KURK: Mr. Ribsam, would you, if possible, stay around for a while because there may be further questions later on?

MR. RIPPLE: Absolutely.

CHAIRMAN KURK: Thank you. And when you come before Division III will you make sure to have all of the financial information in budgetary form, including start dates for these various positions? I don't think they're all going to start on July 1st, 2018.

MR. RIBSAM: Okay.

CHAIRMAN KURK: Thank you.

MR. RIBSAM: Thank you.

CHAIRMAN KURK: And, also, especially Section 5, the $1,100,000 of foster care, how that's to be divided up and the timing.

MR. RIBSAM: Great. Thank you.

CHAIRMAN KURK: Thank you. Chair recognizes Amelia Hogan. Good afternoon and welcome to House Finance.

AMELIA HOGAN, Child Protection Service Worker I, Division of Child Protection Services, Department of Health and Human HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 23

Services: Thank you very much for having me. I am here to give you a slightly different perspective, more of a sort of frontlines' view.

My name is Amelia Hogan and I am a Child Protection Service Worker at the Manchester District Office. For the record, anything I say is my own personal opinion and not necessarily representative of the Division, although I am thrilled to see our Director here.

So I have been a CPSW for two years and one week, and we were talking about worker attrition. I can count on one hand the number of workers in our office who are more experienced than I am. This is a problem because we have the largest district office in the state, and we are currently carrying the highest caseloads in the state.

Want to give you a little bit of an idea of what my job looks like day-to-day. We are mandated by State Law to see every child on our caseload at least once a month face to face. So --

CHAIRMAN KURK: Miss Hogan, could you speak closer to the microphone so that everyone can hear your words. Just bring it right to your -- within four inches of your lips.

MS. HOGAN: All right. Is that better?

CHAIRMAN KURK: Yes, much.

MS. HOGAN: Thank you. So one home visit, including travel and documenting that visit, comes to about two and a half hours. If you have 20 cases, let's say 30 children that we have custody of, that's 70 hours a month doing just home visits. So that's basically half of your entire allotted time. Two weeks of every month is just visiting the children. Having 20 cases also means that you have about 80 review hearings to attend each year and 80 review hearing court reports to write. If you spend four hours on each court report that gives you 320 hours a year writing court reports alone. That doesn't include other legally mandated paperwork, dispositional social studies, absent parent HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 24 affidavit, adoption packets, case plans, other mandate assessments. I would generally round up the number I spent writing for the purposes of court to about 400 hours yearly. That leaves less than one week in every month that we have to actually do the work on our cases. That includes consulting with CASA, meeting with parents, meeting with teachers, meeting with counselors at Methadone clinics, arranging random drug tests, attorneys, parent aides, and if you want to see any children you're working with more than once month you have to fit into that remaining 25% of your time.

So we are in a -- a really pretty awful spot right now. We're terminating parental rights at unprecedented rates. Children are being adopted in numbers that we have never seen before in this state. And part of that is because we don't have the resources to truly assist in reunifying families, which is the purpose of my job. We're seeing a rash of health problems in our office. Secondary trauma which is literally post-traumatic stress disorder that you get from listening to the bad things that happen to other people. We've got that. We've got panic attacks. We have got gallstones. We have got insomnia and none of us are taking any time off. We are just working straight through because if we do, children are put at risk and that's just not acceptable.

So I'm really -- I'm grateful that there has been movement towards addressing the concerns that we're -- the recommendations that were made in the independent review two years ago but it's -- it's not sufficient. It's really not sufficient. I'm happy that this bill proposes additional workers. However, 13 workers gives us one more -- about one more worker per office, and that we need much, much more than that. I'm sure that all of you are more familiar than I am with the disappointment of the reappearance of a bill from Committee that has been transformed into something entirely different, and I'm feeling that disappointment right now because I was really hoping to actually end up with a caseload standards. You know, we were looking for a long-term solution to -- we've been in a state of crisis for almost a decade now. It's proposed that we HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 25 spend $100,000 on a study to determine whether or not we need caseload standards. Your last study already told you that. You know, if this has to be the first step that we take, if this is all we can do, then please, I am literally begging you, please, give us this.

Hum -- if we are going to start the children of our state and prevent future child fatalities, we need to have caseload standards. And if it takes -- if it's a year from now, two years from now, and I will be back here again and I will be testifying on behalf of this bill. You know, the safety of our children, everybody says that that's our priority. Everybody says that they care so deeply and everyone says that they are so outraged that children have died and that children have been harmed. Supposedly it's a party-free issue so it's really hard for me to understand why I have to be here; but, clearly, we are not advocating for our children. And I see everyday children being put at risk, because we don't have any resources at all.

So this Bill 582 represents the scrapingly bare minimum of what must be done in the very near future to protect our children. Myself and, honestly, every single co-worker of mine that I've spoken to about this are all in favor of it. So all of us ask you to please do what you can to move this forward, because this will directly impact our ability to keep the children of New Hampshire safe. Thank you.

CHAIRMAN KURK: Thank you very much. Chair -- Representative Spencer. I'm sorry, Representative Berrien.

REP. BERRIEN: Thank you. Thank you, Miss Hogan, for being with us today and giving us the ground level view that you're dealing with. So we've heard various numbers of 12, 15 cases per worker. From your perspective, what would you see as the ideal number?

MS. HOGAN: I think 12 -- 10 to 12 is a very reasonable number. You know, I've been at various points in that spectrum myself. The highest caseload I have personally ever carried is

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SENATE BILL 582-FN 26

22, and I was barely able to meet the minimum legal requirements to manage that caseload.

Hum -- currently I have 19, and including four or rather not including four assessments so 23. For the record, I am a family service worker. So I am the worker that stays with the family long-term over the course of the entire child protection case. But I have not had a caseload under 15 since I was six months into this job because the worker who was mentoring me left and I was given her entire caseload. So six months in I got 15 and it's pretty much just been up from there.

REP. BERRIEN: Thank you.

CHAIRMAN KURK: Thank you very much. Sorry. Are there other questions? I assumed there were none. Representative Long and then Representative Lewicke.

PATRICK LONG, State Representative, Hillsborough County, District #10: Thank you, Mr. Chairman. Thank you, Miss Hogan. The question I wanted to ask the Director, also I'd like to ask you, I think it's more appropriate, is are there avenues, you know, in order to spend this $100,000 efficiently we're looking at low-hanging fruit as the Director said; rides, appointments, clerical. Do you see a lot of -- a lot of work that you do or what percentage of work you feel like you do that's not your social work?

MS. HOGAN: There are a number of things that I spend a lot of time on that could be delegated. I hear that the Manchester District Office used to have a budget for five support staff. We currently have two. But, yes, I am always giving people rides, making photocopies, preparing discovery for the defense attorneys. Hum -- just absolutely a lot of it could be delegated that's necessary.

REP. LONG: Follow-up.

CHAIRMAN KURK: Follow-up.

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SENATE BILL 582-FN 27

REP. LONG: Thank you. So you're of the opinion that if you could put your resources more towards social work there's space within the current system to be able to do that? You would be better off servicing the child?

MS. HOGAN: Yes, yes, I would definitely be better able to do my job if there were additional support staff.

REP. LONG: Thank you.

CHAIRMAN KURK: Representative Lewicke.

REP. LEWICKE: Thank you, Mr. Chair. That was my question, too.

CHAIRMAN KURK: Representative Spanos.

PETER SPANOS, State Representative, Belknap County, District #03: Thank you, Chair. Miss Hogan, have you found in your experience that some of your colleagues can far better manage the caseload and pressure that you're under than others?

MS. HOGAN: Yes, definitely.

REP. SPANOS: Follow-up.

CHAIRMAN KURK: Follow-up.

REP. SPANOS: So you would say based on your experience that there is a significant disparity in performance overall?

MS. HOGAN: I think as within any workplace there are people of varying ability; but it certainly takes a certain skill for organization to be able to manage the high caseloads that we have now.

REP. SPANOS: Thank you. Thank you, Chair.

CHAIRMAN KURK: Are there other questions? There being none, thank you very much. HOUSE FINANCE COMMITTEE April 3, 2018 SENATE BILL 582-FN 28

MS. HOGAN: Thank you.

CHAIRMAN KURK: Chair recognizes Dolly McPhaul. Good afternoon and welcome to House Finance.

DOLLY MCPHAUL, Member, New Hampshire Division of Children, Youth, and Families Advisory Board: Thank you. I'm Dolly McPhaul. I'm from Sugar Hill. I serve on the DCYF Advisory Board and also on the -- the Child Welfare System's Inter-Agency Transformation Team; but I am here today speaking on my own behalf.

You, the Legislature, have the power and are responsible for the success or failures of DCYF in protecting children and preventing child abuse. You have the power to appropriate funds that are needed to make changes, and you have the power to change or create rules that are needed to protect these children.

It is very critical that you make them a top priority. DCYF has come under scrutiny and criticisms for failing children resulting in the deaths of two in particular. As a result, a number of surveys, studies, and committees have been set up to explore the reasons and the possible solutions. It is no surprise that the problems are understaffing, underfunding, and lack of effective and adequate rules.

In 2016, a study was commissioned by the Center for Support of Families which has become the gold standard of reviews. And in it I would like to make -- read a quote. It says, "We can clearly -- we can say clearly that investments are needed and if the State wishes to hold DCYF accountable for protecting the health and safety and well-being of our most vulnerable children, the agency must have the resources it needs to carry out the mission." It also states, "In particular, the existing workforce will not be able to implement effective improvement strategies until it is not overloaded and stressed as it currently is." It also states, "The agency has to inform the

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SENATE BILL 582-FN 29

State's leadership of the strengths and needs of the system," which we are attempting to do. The ball is now in your court.

SB 580 addresses the staff shortage and foster care. You have heard plenty about the staff shortage. You've gotten the data. You've gotten firsthand information. The foster care system is stretched to the limit, as you've also heard, due to addictions to alcohol, street drugs, and opioids. The situation is very grave. Hopefully, the funding that they're asking for will entice more families to feel they can afford to take part in this project, the foster care and child adoptive services.

DCYF had funding taken away a few years ago when the economic crunch happened. They are not asking for anything outrageous. And, as I said, a child should be your first priority. A child is more important than a commuter rail, than painting guardrails, than new signs on the highway. Picture a child being hit by a two by four in the stomach to the point where he dies. Picture repeated abuse to a vulnerable infant. It is in your power to make necessary changes possible, and I urge you to support SB 582 and the remaining 590 and 592 today. Thank you very much.

CHAIRMAN KURK: Thank you, ma'am. Are there questions? There being none, thank you.

REP. SMITH: I'd like to ask --

CHAIRMAN KURK: I'm sorry, we do have a question. Representative Smith.

REP. SMITH: Thank you very much for coming and being so clear and direct in what you're saying. Would either/or any of the groups you represent be willing to speak out to the general public, not to us, but to the general public, the people who elect us, to speak out about how we must find a way to increase the revenues coming into the state in order to meet essential needs?

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MS. MCPHAUL: Well, I'm sure they would. I would. I'm more than happy to. Hum -- but I -- I just feel that there are places where money can be appropriated, and I feel that taking care of a child who cannot speak or defend themselves is more important than many of the other items in the budget. So thank you.

REP. SMITH: Thank you very much for that. And if you really want to address that issue and give us a list of firms that might be available for this purpose that would be great. Of course, we can't take funds that are required to be spent in certain areas, such as transportation or fire safety or whatever; but any list you can provide the sources we'd be happy --

MS. MCPHAUL: I wish I could do that. That's your problem. don't -- I'm not familiar with your process.

CHAIRMAN KURK: Thank you very much, ma'am.

MS. MCPHAUL: Thank you.

CHAIRMAN KURK: Chair recognizes Moira O'Neill representing the Office of Child Advocate. Good afternoon and welcome to House Finance. If you have testimony to distribute, Mr. Ripple will make sure we get that after the hearing is over.

MOIRA O'NEILL, Director, Office of Child Advocate: Good afternoon, Chairman Kurk and Vice-Chairman Ober, Members of the Committee. As the Chairman said, I'm Moira O'Neill, and I'm honored to speak as the first Director of the Office of the Child Advocate here for the State of New Hampshire. And I apologize. If you'll indulge me, I have a previously scheduled engagement so I can't stay for all three bills. I'll just make brief comments on the three and give you my written testimony.

It's -- if I could also comment on a couple of things that have just been said. Chairman Kurk, you asked earlier of Director Ribsam, where's all this money going to come from? I don't know either as he didn't know where it would come from; HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 31 but I can tell you that waiting to act until a child has been harmed or worse is costing the State a whole lot more money than these kinds of services that will be supported in SB 582, SB 590 and SB 592.

As the Child Advocate for the State, I was only here for a couple of weeks before there was a tragic death. And as the statute mandates, I had to investigate that death preliminary and it was really stunning to find that there could have been remedy to the experience of that child. He could still be alive if only we had voluntary services in place. If he had lived several years ago when the State had voluntary services in place, we might have been able to help that family and averted that death.

I'm very pleased that the case worker, Miss Hogan, was here before to give you a sense of what is the experience of case workers day-to-day working for the Division of Children, Youth and Families. It's very obvious to me, even though I've only looked at a few cases so far, that the performance of case workers is under par. They're not keeping up with their documentation. They're not returning phone calls. All of that is clearly an artifact of being overworked and having too much to do and not able to keep up with things.

What happens when people live in those circumstances is their performance becomes immune to what really needs to happen. Their communications become immune to what really needs to be delivered. And they're just checking off tasks so that they meet their daily requirements, and they're not actually seeing or able to respond to what's happening with children. And I think that Miss Hogan expressed that very eloquently and I'm pleased that she had the courage to stand up here and talk about that.

I want to say that the three bills that I'm supporting all come together as a very sort of wraparound effort in voluntary or preventative services. We're finding that when families are able to get supports, sometimes very simple supports, like parent coaching, access to family therapy, coping skills, training, they're understanding how their children are growing, HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 32 those things will prevent families from getting to the point where children are harmed.

The cost of foster care, residential placements, all of those interventions after the child has already been harmed, been exposed to long-term chronic stress, is really overburdening the system here in the state. The voluntary services approach is also much cheaper because, as I mentioned, the services that you're talking about are much more simplistic. But the other cost is the cost to the child and the child's development. We know very well now for a good 20 years since the first adverse childhood experiences studies came out that a child's brain is developing constantly. And when they're exposed to toxic stress, domestic violence, substance abuse, they're going to have very long-term implications from that. They're not going to be able to learn in school. They're not going to be able to get jobs. They're going to have their own behavioral issues. Many of those kids actually become more expensive to care for because of behavioral issues and chronic medical conditions. So although it seems as though you're being asked to put forward a great deal of funding now for voluntary services, it actually pales in comparison to what you're spending on these other more expensive services.

And I'll just mention that New Hampshire's not alone. Many states have been through this experience, and there's some great studies available on return on investment. Arizona, Minnesota Washington, I'm sure you heard about New Jersey today, they've all shifted their approach to a more voluntary approach, a more prevention approach. In Minnesota they saw a return on investment of $13.49 for every dollar spent in voluntary services. In Washington State one of their parenting programs that targeted the risk for abuse and neglect saw a savings of $2,753 per family. Just benefit at least $20.25 per dollar spent. So there is -- there is a good return on investment in these kinds of a services in the long run.

Today it will be difficult, I'm glad I'm not in your seat, to have to go and look for the money to pay for these things. But if you don't pay for these things now, we are going to HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 33 continuously need to pay more going forward. So that -- I just ask you, please, to support these three bills. I agree with -- with Case Worker Hogan that I wish that there were more positions in the bill. I wish it hadn't been cut because the workforce issue is definitely feeding into the problems of the agency to be able to function as it needs to and keep kids safe. And I'll just add that I'm sure most of you in this room have flown on an airplane before. Airlines are not able to allow their pilots to fly if they're tired or if they have flown too much this week, because there's a danger of harming people; and yet, we send case workers out every day to prevent children from being harmed or killed. And we don't care how many hours they put in or how much work they have on their laps. So we can't expect them to perform and to keep our kids safe and to grow a healthy population who will be our workforce and feed into our economy in the future unless if we start addressing these issues now with the system. So thank you very much for your time.

CHAIRMAN KURK: Thank you very much. Would you please provide us with citations to the various studies you mentioned? Also, if there's anything on a cost benefit analysis which is quite different from the programs you mentioned that perhaps results first out of the Pew Foundation has developed we'd appreciate that information, also.

MS. O'NEILL: I'll get that to you.

CHAIRMAN KURK: Thank you. Are there questions for the Advocate? You're getting off lightly.

MS. O'NEILL: Thank you. Maybe you're getting off lightly.

CHAIRMAN KURK: I hope you'll make yourself available when Division III works on these bills. Thank you. Chair recognizes Keith Keunning. Good afternoon, sir, and welcome to House Finance.

KEITH KEUNNING, Director of Advocacy, Child and Family Services: Thank you. Mr. Chair, Madam Chair, Members of the Committee, thank you very much. My name is Keith Keunning. I'm HOUSE FINANCE COMMITTEE ApriI3,2018

SENATE BILL 582-FN 34 the Advocacy Director at Child and Family Services. I will be very brief because many of the things that I want to say have already been said. One of my favorite sayings is "a vision without resources is an hallucination." I think all of these bills, including this bill and the other two bills, are the resources we need to make the vision of what we want to achieve here in New Hampshire come true, and what is that vision? We want children to be protected from abuse and neglect in this state. That is -- that is our goal. Do we have trouble? Yes. We currently still have trouble.

As Director Ribsam said, we doubled our foster care placements in the last three years. The Commissioner testified over the summer that normally we get about 1100 calls through a month to DCYF. Over a three-month period we usually get about 3300 calls. We've received 5,000 calls over a three-month period. Our foster care rates are low, over about $16 an hour compared to a national rate of $24 an hour. Our organization provides foster care and we have foster care families. And for the first time we're hearing is that foster care families are saying they simply can't afford to bring in more children. The rather sad joke in the foster care community is they get so little money for clothing, they have to buy one shoe in April and one shoe in May, because they get so little money to take care of the kids. Our workers are telling us that the families that they're dealing with are in deep crisis, more crisis than they normally see. And that we know from what Joe Ribsam said and that I heard before that in some of our District Offices before Director Ribsam came in, there was a 50% turnover rate in some of our offices every two years. So just imagine that that we have six months to train somebody, they're there barely 18 months and they move on. Those are all the bad things that are happening.

What are the good things? Well, for the first time I feel like this state in a decade understands we have a real serious problem here, and it's being brought before the Legislature. I would say one of my highest criticisms over the past ten years, and this is before the current leadership has been coming over to HHS, is that I felt like things were not brought to the HOUSE FINANCE COMMITTEE April 3,2018

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Legislature and you're not told what was going on. You were not told that we have one of the lowest foster care rates in the entire country. You were not told that we have some of the highest cases per case workers in the entire country.

So what do we have going for us at this point? We have a vision. We know where we want to go. We have the leadership. I think Commissioner Meyers has done a great job bringing in Chris Tappan and Joe Ribsam. They have had experience with this. They know what direction we need to go in, and we just need the ability to get the resources to solve the problems to protect our kids. So thank you very much.

CHAIRMAN KURK: Thank you, sir. I have a question, a rather basic question. All these bills are basically Band-Aids. We have a crisis now. We have to solve it. What's the cause of this and how do we deal with the causes so 5, 10, 20, 50 years down the road we're not faced with the same situation?

MR. KEUNNING: Well, thank you for the question. I think the explosion, and I think Director Ribsam might be able to talk to it. I mean we know there's a direct correlation between the opioid crisis that's going on and the number of children that are being placed in foster care; but I would respectfully somewhat disagree. I think the three bills together are more than a Band-Aid. I don't think it's going to get us all the way that we want to get; but by the time you add the voluntary services and the new workers and the leadership --

CHAIRMAN KURK: I'm not talking about that. The question has to do with why our society produces these kinds of situations that people feel that the Legislature needs to step in? The collapse of the family, changing social values on what it means to have children? What is it that we might look at so that in addition to putting a Band-Aid, and these bills with all due respect I believe are a Band-Aid for the situation we're facing, that we can do something that might avoid this or certainly reduce the number of these kinds of situations in the future?

MR. KEUNNING: Thank you for your question. HOUSE FINANCE COMMITTEE April 3,2018

SENATE BILL 582-FN 36

CHAIRMAN KURK: Is that over your pay grade?

MR. KEUNNING: I was going to say I think you're asking more of me than I can provide you, Representative. I know we have societal problems. I do know getting to children early and helping families early can make a difference. And I think these three bills provide that ability for the Department to do that.

CHAIRMAN KURK: Thank you. Representative Rogers, then Representative Weber.

KATHERINE ROGERS, State Representative, Merrimack County, District #28: Yes. You talked about the national foster care being $24 an hour, ours is 16. Looking ahead, and as Representative Kurk and you debate about whether it's a Band-Aid or not, looking ahead to the next budget we're addressing, if these three bills go through, we have the study and so forth, putting on your -- your looking-ahead vision, so forth, what do you see coming in in the next budget as far as the foster care cost that we are going to be looking at if we move in this direction? And it is a step. What do you see that we are going to be looking at for that next budget with the foster care?

MR. KEUNNING: Yeah, thank you for the question. I don't think money should ever been a motivator for somebody to become a foster care parent. That is not what you want them to do. Should also not be an inhibitor and at $16 a day there are families that are being inhibited from becoming foster parents. I don't think that we can jump immediately to $24 an hour -- $24 a day. There was work that put some money in the foster care system last time. My feeling is from talking to our staff that if we could get somewhere around $20 a day that would make a huge difference for a lot of families whether they would be able to take children in or not.

I mean, for some of these families, you know, for some families, God bless them, they have enough money that the money makes no difference. But there are really motivated people out there that want to become foster care parents that simply can't do it on $16 a day. So if I had a goal to look at, it would be HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 37 about $20 a day for our basic foster care rates as we look into the next budget.

CHAIRMAN KURK: Follow-up.

REP. ROGERS: Follow-up. If we went to that $20 in the next budget that would stop the inhibition you're talking about of people dropping out of the system as it is now and would help us, and with the growth we're having would help us and at least be a little bigger Band-Aid maybe than --

MR. KEUNNING: Yes, thank you for the question. As I said, I think there are families that simply look at the numbers. And if they're already on the edge, and they're already having trouble meeting their heating bills and so forth and so on, the $16 a day scares them away from being foster care parents. As Director Ribsam said, we had a doubling of foster care needs in the last three years. And we need to bring these families in, because the thing you have to understand is you don't want to have 800 foster care families for 800 foster care children. You need some ability in the system to be elastic to make the placements in the correct places. So you don't want foster care children placed from Nashua up in Berlin or Berlin over. You want to make sure that the parents fit the child correctly. And I've heard some people talk about as devastating as it is to be taken away from your parents, it's even more devastating to be taken away from your foster care family because it's not a good fit, because then the child starts to think there's something wrong with the child, that they're continually being moved from foster family to foster family.

So by increasing the rates, you'd probably get more people involved and more people involved means you give the system more flexibility in order to find the placement that's correct for the child.

CHAIRMAN KURK: Representative Weber.

REP. WEBER: Thank you, Mr. Chairman, and thank you for taking my question. To go back to the Chairman's question about HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 38 the underlying societal root causes, is it fair to say that whatever the underlying root causes are the most effective and the most cost-effective interventions are the ones that we have none of now, which is providing supports to families before they fall apart and helping parents continue to parent their own children, and is that not the direction that we ought to be looking for the future?

MR. KEUNNING: Yes, thank you for your question. Yes, absolutely. I mean, where you want to put the money is upstream, right? You want to build a dam before you have to clean up the town downstream after it's flooded. And so anything that we can do to keep the children with their families, to keep them out of the foster care system is where we want the money spent. And you're exactly right. There is no money for these voluntary services right now. And so that money will make a huge difference not only in the lives of these children and families, but it should take a lot of pressure off of the workers at DCYF. If the children are kept in the homes, then those numbers of cases per case worker should not increase that much because you're not putting them into the system. And that's why voluntary services are just so utterly important in these bills.

CHAIRMAN KURK: Thank you. Is there anyone else who wishes to ask question? Representative Berrien.

REP. BERRIEN: Thank you. I'm aware that national data shows us that child abuse and neglect is actually decreasing in this country, although the latest data shows that fatalities have actually increased, unfortunately. So we hear in the state from Director Ribsam that our numbers seem to be increasing. Hum -- would you speculate -- speculate if you like that one of the reasons why we are having a problem in this state is that as you had indicated the Legislature wasn't aware of the problems and were we therefore neglecting this problem from a resource perspective over the past decade?

MR. KEUNNING: Yes, thank you for your question. I mean, if people are constantly telling you the bridge is fine, the bridge is fine, the bridge is fine, you know, I heard one time they HOUSE FINANCE COMMITTEE April3,2018

SENATE BILL 582-FN 39 say, you know, in politics we deal with what is necessary first. And so if you as a legislative body are told over and over again that everything is okay in the foster care system as been happening over the past, you know, ten years up until about the last year, then the Legislature deals with the other problems they have; mental health, opiates, and so forth. But what we have now, and thank God for this, is we have the truth in front of us. Sadly, from the stories from the Concord Monitor, from the deaths of these children, from new directors that are willing to walk in here and tell you the numbers and where we are, we're able to make those choices now. And so, you know, I think this is for the first time, and I would agree with one of the people that testified before me, it's in your hands now. You know what the problem is. You know what needs to be done. And the Director and Chris and others have a vision for you how to get there. So it's up for you as a legislative body to figure out what resources you want to give them in order to achieve the goals to protect New Hampshire's children.

CHAIRMAN KURK: Thank you, sir. We appreciate your testimony.

MR. KEUNNING: Thank you.

CHAIRMAN KURK: Chair recognizes Adam Steel. For Members of the Committee, if you wish to ask a question, just raise your hand. I'll write your name down and recognize you in the order in which you raised your hands. Good afternoon, sir. Welcome to House Finance.

ADAM STEEL, Co-Chair, Child Welfare System Transformation Team: Good afternoon. Thank you for having me. I'm here in a number of different roles. I work for a school system in the Mont Vernon-Amherst-Souhegan School District. I've been a foster parent for a number of years. I teach classes for perspective foster parents and also work to recruit new foster families.

I'm here today as the Co-Chair of the Child Welfare System's Transformation Team that's been meeting over the last HOUSE FINANCE COMMITTEE April3,2018

SENATE BILL 582-FN 40 several months. I want to make sure that the Committee is aware of that team represents stakeholders from various groups including DCYF, the Director of Office of Child Advocate, Moira O'Neill, Chris Tappen sits on that Committee, Senator Reagan, Representative MacKay, members from the Coalition against Domestic and Sexual Violence, CASA of New Hampshire, the organization that runs CAC Centers in the state, child and Family Services, Attorney General's Office, State Police, and foster parents among others. We fully support all three of these bills that are before you today, and they align with our goals and our work that we have done over the last several months.

To Director Ribsam's answers about where some of the numbers came from, I do want to share with the Committee that the bills came forth during the time that our Committee and our team was working towards recommendations for some things. And so Director Ribsam is working to catch-up with the Legislature in this regard, and we are pleased with that outcome. So I won't repeat a lot of what was said before; but a couple of words I want to highlight from other folks' testimony.

One is the word elastic. We are responding to the crisis that's come before us the last several years. We have prioritized within DCYF the most egregious cases and the highest needs for our kids. As a result, we've forgone prevention services and volunteer services and things that really could help families. And what we need to do is develop an elastic workforce that can expand and contract with the needs as they are arise.

And then a hypothetical story which may or may not be true. Two kids that lived with a family I know awhile and I may be a part of, were with us for a year. They were reunified with one of their parents who did the good work over that year. But a few months later that parent suffered some hard times and needed some help. Because of the status of the Division right now, those kids went back into care and are now looking for adoptive homes and may or may not have entered residential care as well in the interim. Those are two children whose lives are forever different now because of the absence of voluntary and HOUSE FINANCE COMMITTEE April3,2018

SENATE BILL 582-EN 41 preventative services that could have been available for that particular family.

The other word I want to highlight is upstream. This is the Finance Committee and so I want to talk about the financial impact of these bills. We are, because of the crisis situation that we're in, we are paying the most expensive interventions we probably can for kids. And until we start making the investment upstream with the services that are needed at the beginning of the process, we are going to have to pay both ends of the spectrum for a while; and that's unfortunate for all of us and all of us who pay taxes. Until we make that investment and get ahead of the game, we are going to be behind the curve for a number of years. With that, I would be pleased to answer any questions the Committee may have.

CHAIRMAN KURK: Thank you, sir. Could you tell us when we are going to see the downstream savings and are they simply avoided costs or actually reduction in a budget line?

MR. STEEL: Yeah, I cannot predict the future. I think that Director Ribsam's experience in New Jersey would be telling and would be compelling for us about how long it took to reverse the trend; but I'm not an expert in that field, and I would expect savings across the board over time.

CHAIRMAN KURK: Thank you. Questions from Committee Members? There being none, thank you again, sir.

MR. STEEL: Thank you.

CHAIRMAN KURK: Chair recognizes Laurie Pelletier. Good afternoon. Glad you're here.

LAURIE PELLETIER, Internal Organizer, State Employee Association: Thank you. I am --

CHAIRMAN KURK: Could you identify yourself for the record?

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SENATE BILL 582-FN 42

MS. PELLETIER: My name is Laurie Pelletier. I currently work for the State Employees Association. Formerly I worked for Child Protective Services, and I worked in the Concord District Office. I was an adolescent worker, which is a family service worker, and I specialized in adolescents 14 and older that came into the child protective services. And I'm here representing my former job as a CPSW and want to thank everybody that's been testifying. It rings to me in my heart.

When I started as a family service worker or working for DCYF it was my passion. And I was -- I grew into the position. I loved it. And I, unfortunately, got to a point around the 16th year mark that I could no longer be effective. So a lot of the things that people are testifying to as far as burnout, post-traumatic stress disorder, it hit me and when it did it was horrible, because it put me in a position of leaving my co-workers, leaving my -- I refer to every child on my caseload as my kid. I took ownership for every child I worked with. And so it was leaving them and it was almost like leaving my own children, and it was the most difficult decision I made in my entire life. But it was necessary for me to make that decision and I feel very honored to be able to help on another level to help the CPSWs to have better working conditions and to help them have the resources that they need. So this gives me the opportunity to testify that everything that people have been saying is true.

I worked with families -- foster families. I worked with agencies, foster care agencies, foster parents, adoptive parents, and there was a lack of resources. And I think when I first really started to get involved I had heard, and I don't know if this is true, but that our prior directors had not even asked for a new position since '05, '06 for CPSW and that made me very angry because that meant that you folks didn't know what people were going through. And I can say that it was back in '05, '06 that we could have really started using those resources. And had we received them, maybe we wouldn't be in such crisis as today, and maybe kids would be safer, and we would have the resources and we wouldn't be in such a crisis.

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SENATE BILL 582-FN 43

So I hope that our Legislature now is aware that we need the resources. We need to find those funds. Everything points to the direction that if you can prevent whether it's health or mental health, preventative medicine, it's always better. Well, preventative services are going to be better in the long run for all of our families, for all of our children. So I hope that we can find the money.

I feel that you're all elected, but it's up to every person in the public, and I'd be happy to try to spread the word to the public I don't know how you get people involved. That's part of my job now. And trying to get people to be involved in society which maybe addresses Representative Kurk's question of where does things lie.

Nobody in this room is a fortune teller I don't think but -- and you can't foresee the future; but we do have to make improvements across society, I think. And I believe that every single person is responsible for that. And I'm hoping to get more people involved. So thank you very much. I'd be happy to answer questions.

CHAIRMAN KURK: Thank you very much. Representative Itse has a question, followed by Representative Hatch.

REP. ITSE: Thank you very much, Mr. Chairman. Miss Pelletier, to put things in the frame of reference, when did you find yourself having to leave your position as CPSW? When did you find yourself having to leave your position as a social worker?

MR. PELLETIER: I left -- I actually went out on family medical leave act a few months prior to my final resignation, and I left October 28th of 2016.

CHAIRMAN KURK: Representative Hatch.

WILLIAM HATCH, State Representative, Coos County, District #06: Thank you, Mr. Chair. Thank you for your testimony, and I mean it sincerely. I hate to hear it, but thank you for your HOUSE FINANCE COMMITTEE ApriI3,2018

SENATE BILL 582-FN 44 service. My DNA is not made to do what you did, and I'm a father of many. So I think what you're saying just to capsulate a lot of the testimony, I think it truly does at times, would you agree, it truly does take community to raise a child and we're all responsible, we all should be involved. Does that kind of capsulate that?

MR. PELLETIER: I do believe that. It needs -- it's -- but DCYF is responsible for ensuring children safety. And they're the agency that is given the responsibility to take care of the children, our most vulnerable citizens of this state. So although I do believe it's every person's duty in the state to ensure that they are doing the best by every child in the state.

REP. HATCH: Thank you. Thank you, Mr. Chairman.

CHAIRMAN KURK: Thank you very much, ma'am. Oh, wait. I'm sorry, your name?

MARY JANE MULLIGAN, State Representative, Grafton County, District #12: Representative Mulligan.

CHAIRMAN KURK: Representative Mulligan.

REP. MULLIGAN: Thank you, Mr. Chairman, and thank you for taking my question. I'm not exactly sure that you're actually the right person for me to ask this question to. But I am relatively new to the -- to the legislative, you know, to the House. And so I guess I'm hearing over and over again that the legislators, that the people here in the House and in the Senate weren't really aware of what was going on in one of the largest -- I would assume it's a pretty large Department here in New Hampshire. And I just -- I guess I don't understand how we didn't know and you said back in 2005 and 2006 you thought if something had been done then. I mean, that's quite a few years ago. Why did it take so long for us to become aware of the problem that is so critical to our constituents, to the people of New Hampshire?

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SENATE BILL 582-FN 45

MR. PELLETIER: You know, I'm not sure if I am the right person to answer that. I have my own opinion. I think that our -- some of our former leadership at DCYF maybe they weren't representing the truth or what we were being told on the frontlines is they were asking and we weren't getting the funds that we needed. I don't believe they were asking. I don't have any proof to that. That's just my opinion. Because somebody shared with me that we hadn't actually asked for new positions since '05, '06. And, again, I'm not sure if that's factual but it seems like it, because that seems to me, I started with the Division in 2000 and around that time is when we started seeing positions taken away rather than being increased. We were losing positions. And I testified to the Commission on Fatalities that we needed more human resources, as well as technological resources. And we weren't able -- the folks weren't able to find some resources that we greatly needed to do our jobs better in the field.

And so I think -- I feel, personally, when the legislative body is aware of the needs that are out there that they have been responsive. But we need to continue that and, you know, don't know. I remember when I first started we used to have legislators come into the Concord District Office to see what it was like in the day of a CPSW. And when I first started with DCYF, I actually was a single parent and could have qualified for TANF benefits because of the pay grade was so low. So I worked two jobs instead. But just to give an idea of --

CHAIRMAN KURK: Thank you very much. We appreciate your testimony. The last person who submitted a pink card is Richard Gulla, representing the State Employees Association.

BRIAN HAWKINS, Government Relations Coordinator, State Employees Association: Mr. Chairman, he had to go. I'll just -- for the record, Brian Hawkins, State Employees Association. I'll just quickly summarize his testimony and hand it in in the interest of time.

We initially started to work on this piece of legislation a couple of years ago in response to the pressures that our HOUSE FINANCE COMMITTEE April 3,2018

SENATE BILL 582-FN 46 members were seeing on the frontlines. I think you heard those very clearly today. And I'll just add that, you know, I think this bill while it is not what it was in its original form, it's a bridge, I think, within a Band-Aid to the next budget where we can continue to address those caseloads in a small way, but also take a really in-depth look over the course of the next number of months so that we can give both the Department and the Legislature a clear idea of where is it that we need to be when we set that next two-year document, the budget, and that will give us the information that we need. So here in support of both the -- the study and the additional positions. Want to thank Senator Carson for her advocacy, as well as support of the Senate and the Governor. Thank you.

CHAIRMAN KURK: Thank you, sir. Representative Long has a question.

REP. LONG: Thank you. Could you tell me the process with which the union would express their concerns for something happening within this instance, the DCYF? What would that process be? Is there a process?

MR. HAWKINS: Well, over the last couple of years especially we have been working, both with the Department and through the Legislature, to advocate for better funding. I think, ultimately, originally we would have preferred a set standard, something along the lines of what the National Child Welfare Protection League would have recommended. But I think as Director Ribsam said, you know, we want to find something that makes sense for this particular Department, and I think that's what the study does. And I think this provides for the workers, who ultimately are there to protect the kids, this provides them a light at the end of the tunnel.

The other thing Director Ribsam said was we're hiring people. We are having a retention problem. You know, I think the Legislature and the Department showing those workers that we are continuing to invest in additional people, I think that will help with the retention issue more so than even -- and this is coming from a union guy -- but even more so than the pay. But HOUSE FINANCE COMMITTEE April 3, 2018

SENATE BILL 582-FN 47 think this will help with that -- that retention issue and put us in a better position next year.

REP. LONG: Thank you.

CHAIRMAN KURK: Thank you, sir. May we have a pink card from you?

MR. HAWKINS: Yes.

CHAIRMAN KURK: Is there anyone else who wishes to testify on House Bill five -- Senate Bill 582? Following -- sorry. Eighteen people signed up on the blue sheet expressing support of whom five were either Members of the Committee or already testified giving us a net of 13 people who did not speak wish to express support. No one signed up in opposition. There being no one else who wishes to testify, the hearing on Senate Bill 582 is now closed.

(The public hearing concluded at 2:33 p.m.)

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SENATE BILL 582-FN

CERTIFICATION

1, Cecelia A. Trask, a T..icensed Court Reporter-Shorthand, do hereby certify that the foregoing transcript is a true and. accurate transcript from my shorthand notes taken on said date to the best ofoo myability,ability, skill, knowledge and judgment. e<9 -0;00 ▪ 11..A rr% i) o /3 L.-. r Y 4?. • rvA.L. 5•.1 TA ,s3 WC AZ Cecelia A. Trask, LSR, C.RR I; 1/0,111-09J,i State of New 'Hampshire lige:A/LW .1‘ License No, 47 1.'141111100" Testimony My name is Amelia Hogan, I have been a Child Protection Service Worker for 2 years and one week in the Manchester District Office—the largest DCYF office in the state, and carrying the highest caseloads. I can count on one hand the number of workers we have left with more experience than myself. Disclaimer, my views are my own and not those of the Division.

First, I want to show you what my job looks like. 1 home visit comes to a 2.5 hour task between the actual visit, travel, and the documentation. 20 cases, let's say 30 kids, that's 70 hours a month doing monthly home visits. That's 2 weeks of a month just visiting the kids as is legally mandated, not working on the case.

20 cases means 80 review hearing court reports a year. 4 hours per review hearing report is 320 hours a year. That's 30 hours a month writing to report on the case to the judge. To include other legally mandated paperwork, including dispositional social studies, adoption packets, absent parent affidavits, case plans, and mandated assessments, I would round that number up to almost 400 hours annually writing reports.

That leaves less than one week per month, proportionally, to actually work on the case: Go to court, meet with parents, teachers, therapists, special ed meetings, FAIR meetings, methadone clinic monitoring, random drug testing, setting up visits, consulting with CASA and attorneys and parent aides, supporting foster parents... Not to mention mandatory staff meetings, trainings, and supervision.

50% of our time is spent monitoring the case. 25% is spent reporting on it. We are left one quarter of our work year to actually do our jobs.

No wonder parental rights are being terminated at unprecedented rates. No wonder children are losing their parents forever. No wonder we have no foster homes left. We are not supporting anyone. We are under actual threat of being held in contempt of court because our jobs are literally impossible in the current public health crisis. We have depression and panic attacks, we have gallstones and family deaths, we have PTSD, secondary trauma from listening to the horrible things our parents and children have gone through, day in and out. But we can't stop, not even to advocate for ourselves, because children will be put at risk if we do.

I am grateful that there has been some movement toward addressing the staffing crisis faced by DCYF, as recommended by the independent review commissioned by this body. And I am happy that this bill proposes further additional positions so that we can adequately protect and serve the children of New Hampshire.

I'm sure you are far more familiar than I with the disappointment of the reappearance of a bill from committee, magically transformed into something unrecognizable. This bill was initially advocated for by state child protection workers as a long term solution to our now nearly decade- long state of crisis and chaos. Instead, it is proposed that we spend $100,000 on a study to determine whether or not we need what we say we need. To find out if we need something that was recommended by the last study that was commissioned. Please, if this is what has to be the first step in our journey toward establishing a system in which children are safer, then take it. Vote for this bill, give us one new worker per office and then wait for the study which will tell you what I am saying right now: that in order to ensure the safety, permanency and well-being of all of our kids, we must implement caseload standards.

And a year or 2 from now, when there is a bill before you that recommends caseload standards, I will be back; this is the second time I have testified in support of this bill. And I will say I told you so. The safety of our children is reportedly everyone's priority, and a party-free topic. So it is hard to understand why I need to be here. The bill before you today represents the scrapingly bare minimum of what must be done in the very near future to prevent child fatalities. Myself and my coworkers implore you to pass this bill and take a step forward. Your vote for this bill will directly affect my ability to monitor, support and above all protect our kiddos.

Thank you for your time,

Amelia Hogan, CPSW. The State Employees' Association of New Hampshire, Inc. owclLA Service Employees International Union, Local 1984

SEIU CTW, CLC

Representative Neal Kurk Chair, House Finance Legislative Office Building 33 N State Street Concord, NH 03301

April 3, 2018

Chairman Kurk and honorable members of House Finance,

I am writing to you to express my full support for Senate Bill 582 as amended by the Senate. It is quite apparent to us all now that this has been a long-standing problem, many years in the making. This came to a head after the deaths of two children that shook the state a few years ago. We began meeting with child protective service workers who came together to address inadequate staffing, high caseloads, lack of technology and resources and other concerns. At the same time, and drawing on those members' experiences, we negotiated a contract provision to convene a committee with DHHS that would jointly recommend caseload standards for a number of work areas in the Department, including Child Protection. We finished that joint report with DHHS in January of 2017. Also, in December of 2016, the independent review by the Center for the Support of Families called for large increases in staffing, reducing caseloads, and many other changes. To the Department's credit, following that review, for the first time in many years and through attention paid to the review by the Legislature and Governor, DHHS requested and the Legislature funded and filled more CPSW positions in the current budget.

However, as I listen to members' feedback and experiences, there is more work to do, especially with Family Services. Caseloads for both Assessment and Family Service workers are still unmanageable. The CPSWs are often our best chance to prevent abuse and neglect. They need more support from us so they can do this critical work in a sustainable way. For example, I have heard from members who tell me they sometimes cannot sleep at night because they are consumed with fear that a child on their caseload might die. That is not a fear most people have to live with and it is not because of alack of anything that worker has done. It is because they are responsible for too many children, too many cases, and they wonder each day if something fell through the cracks. Did I not do something that could have kept a child safe?

These workers need time to engage in a meaningful way with these children and families. The bottom line is they need lower caseloads We need to have a goal of where we need to be which is why this bill is so important. We need an appropriate standard against which we can measure our progress. We also need to take further steps in making that progress by funding this modest addition of child protective service worker positions now.

207 North Main Street Telephone (603) 271-3411 5E3 PA Concord, NH 03301 Fax (603) 271-3500 The original bill would have set a caseload standard for assessment and family service workers based off national standards recommended by the Child Welfare League of America and from our workload standards committee. That legislation would have then also funded many more positions than the bill before you in order to meet those standards. The Senate as well as the Department felt we needed this more thorough New Hampshire assessment of appropriate workloads while also funding a smaller number of workers to help assist with the critical need we have now. While not everything we would have wanted, we support this measured approach for this year and look forward to working with you all to make even further strides in the next budget.

I want to thank the committee for their time and attention as well as Senators Carson, Bradley, and the bipartisan group of sponsors of this legislation and the Governor for his support of this bill. I urge you to find Senate Bill 582 ought-to-pass.

Respectfully submitted,

ti C)L3 Richard Gulla President SEA, SEIU Local 1984 Dorothy (Dolly) McPhau PO Box 601 Sugar Hill, NH 03586 Home: (603) 823-8450; Cell (603) 305-6975

April 3, 2018 Re: SB 582 Let me begin by saying "you", the legislature, are the key to the future success or failure of DCYF in protecting children... and preventing abuse. There is nothing more important. This should be everyone's priority.

You, the legislature, can provide the funding to make DCYF efforts affordable

and

You, the legislature, can support bills that change laws needed to protect our children.

Without the necessary rules and funding, measurable improvements cannot happen.

DCYF, as you all know, has recently been the focus of much criticism regarding their failure to protect children under their care. Studies have been done by numerous organizations and many committees have been established to identify and rectify the problems... The conclusions are no surprise. DCYF is understaffed, underfunded, and must abide by, in some cases, inadequate and ineffective laws. The three bills before you today, SB 582, SB 590 and SB 592 are critical in addressing some of these problems.

In April 2016, an independent review of DCYF by the Center of Support for Families was instituted by the Governor. An extensive review was conducted. It appears to be the "Gold Standard of Reviews," as it is the review routinely referenced. I would like to quote the review when it was discussing its findings and the need for investment by the state, "...we can say clearly that investments are needed and if the state wishes to hold DCYF accountable for protecting the health safety and well-being of its most vulnerable children, the agency must have the resources it needs to carry out that mission." "In particular, the existing work force will not be able to implement effective improvement strategies until it is not overloaded and stressed, as it currently is." It also states the agency has to inform the state's leadership of the strengths and needs of the system...which we are attempting to do. The ball is now in your court. SB 580 addresses the staff shortage and foster care. One of the major problems has been a shortage of assessment and case workers. The situation has been quite bleak with caseloads stacking up, assessments not completed and workers either resigning or taking leave. It has been overwhelming. Fortunately, progress has been made in that arena, but there still needs to be more staff and more supervisors. The supervisors, who have been filling in for the shortage of other workers, as well as being diverted to train workers, have, of course, had their own workloads suffer. A certain number of people can only do so much. SB 582 appropriates reasonable money for staff, as well as the reasonable money for foster care services. Due to the alcohol, drug and opioid addictions, there is an increasing need for foster and adoptive care. Finding more people for foster children is a problem in itself, but even if/when they can be identified, there is training, certification and oversight involved...all takes staff and monies. Rate increases for foster families will hopefully make it more affordable for families to participate and help alleviate the shortage. DCYF is not asking for outrageous amounts of money and we need to be remember DCYF had monies taken from their budget by the legislature in cost cutting efforts several years ago. One final point... I listened to a man testify recently who was so concerned with a person's rights against possible unfounded accusations made by a neighbor, that he was against legislation important to protect children. THE JOB OF DCYF IS TO PROTECT THE CHILDREN... NOT CAPABLE ADULTS who can speak and defend themselves. THE CHILDREN MUST COME FIRST.

The same holds true with the legislature. The children MUST come first...before a commuter rail, before renaming a bridge, before painting guardrails or giving money to the homeless. The children cannot speak for or defend themselves. They should be our priority. I urge you to support these legislative bills today. Thank you for your time. Dolly McPhaul

State of New Hampshire

Office of the Child Advocate Moira O'Neill

Director

TESTIMONY OF MOIRA O'NEILL, DIRECTOR Before the House Finance Committee April 3, 2018

Good afternoon Chairman Kurk, Vice Chairman Ober and members of the Committee. My name is Moira O'Neill and I am honored to speak before you today as New Hampshire's first director of the Office of the Child Advocate. Thank you for allowing me to explain my support for three proposed bills outlined below. They include SB 582, SB 590 and SB 592.

SB 582 Authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor. This bill raises $100,000 for a study to determine the appropriate case load for child protection workers in the Division of Children, Youth and Families. It also appropriates $1,100,000 for the hiring of 13 new caseworkers and 2 casework supervisor to meet immediate and recognized shortages while we await the results of the caseload study to determine the ultimate workforce needs.

SB 590 Making a supplemental appropriation to the state loan repayment program and relative to emergency involuntary admissions, the child protection act, and the developmental disabilities wait list and making appropriations therefor. My support of this bill is specific to the appropriation of $1,500,000 to fund voluntary services for families who are not found to be abusive or neglectful of their children but who are in circumstances that put them at risk. This bill removes the requirement that families reimburse the state for services received, which is a hardship and a disincentive to taking advantage of available supports. The bill also reinstitutes community-based prevention services to provide supports before families reach the level of a referral for suspected abuse and neglect.

SB 592 relative to the child welfare system . I support this bill to further stabilize the DCYF workforce. These positions will address the overwhelming onslaught of families struggling with substance use disorders that have profound effect on family functioning, child safety and our child welfare system.

Mr. Chairman and members of the Committee, I understand the difficult task before you preserving the state's limited and precious financial resources. But these three bills represent our obligation as a state to protect and preserve our most precious resource: the children. We are a small state and like other northeastern states, our birthrate is not that high. We need to protect the children we have so they grow and develop into a healthy workforce. Waiting to spend money only after children are harmed is a poor investment in New Hampshire's future. Like many states, New Hampshire has struggled to protect children in the last decade since the economy crashed. The cuts that were made in prevention services exacerbated the struggles that families were facing at the same time. Spikes in children coming into state care reflected those cuts. We have failed to help families before escalating stress and lack of parenting knowledge resulted in harm to the children. A number of tragic deaths awoke us to the need for change like establishing the Office of the Child Advocate. But child deaths are rare. Chronic borderline neglect and abuse are more common. They have lasting effect on the development of children's brains and subsequently their ability to do well in school and get jobs. More immediately, children exposed to adverse experiences are more likely to develop problem behaviors and chronic medical conditions that make them difficult and quite frankly expensive to care for. Prevention services save money on every level, the outcomes in other states are proving that.

In a similar effort to establish and support prevention services as these bills would, Minnesota implemented a shift to conducting family assessments on lower risk families instead of traditional abuse/neglect investigations. The state's return on investment was a savings of $13.49 for every dollar spent. Washington state also implemented a number of prevention services including a parent training program targeting risk factors for child neglect and physical abuse. A review of studies applied to the SofeCore program found that Washington saved $2,753 per family with a benefit of $20.25 for every dollar spent.1 Prevention services stabilize families, build parenting skills and divert children from expensive placements. In the case of children with mental health conditions, multi-state studies have documented cost savings in lower rates of psychiatric inpatient care when pro-active community-based preventative approaches are employed2.

SB 582, 590, and 592 represent a wrap-around approach to preventing the drift of families from stress to neglect and abusive situations. in my short time here I have seen the full continuum of failure. Most notably I saw the failure of the system to prevent a tragic death of a 6-year old because there were no voluntary services to offer his family. At the other end of the spectrum 1 have reviewed DCYF cases with incomplete documentation and received complaints of caseworkers not returning phone calls or delaying paperwork necessary to keep permanency planning on schedule. These seem like small transgressions, but every day a child lives under the stress of uncertainty, that child's development is hampered. These are symptoms of a deficient system. That deficiency represents increased costs ahead, for special education, mental health and substance use treatment, medical care for chronic conditions, and the cost of incarceration and lost wages — all predictable costs associated with exposure to adverse childhood experiences. The 3 bills before you are also not enough, but they are a start and they signal recognition that there is no saving in not spending. I urge you to invest in the care and safety of children now by passing these bills favorably. Thank you for the opportunity to speak. I am available to answer questions or help you in any way I can.

1 Calculations are drawn from the work of the Washington State Institute for Public Policy: http://www.wsipp.wa.gov/BenefitCost 2 https://gucchdtacenter.georgetown.eduipublications/SOCReturnOnInvestmentISsueBrief.pdf STATE OF NEW HAMPSHIRE OFFICE OF THE GOVERNOR

CHRISTOPHER T. SUNUNU Governor

April 2, 2018

Finance Committee , New Hampshire House of Representatives State House Concord, NH 03301

Re: Senate Bills 582, 590 and 592

Dear Chairman Kurk and members of the Finance Committee,

I write to you today in support of three major pieces of my legislative agenda that are critical to supporting our states mental health system and the Division of Children Youth and Families (DCYF).

Last year, with the help of this legislature, we began making critical investments in these areas with House Bill 400 and the state budget. We also rebuilt, redesigned, and re-engineered the child welfare system with new leadership. Failing to fix our state's DCYF, mental health system, and our foster care system are not options. They, along with caring for the members of the developmentally disabled (DD) community, are not areas that we have the luxury of putting off for another day. These were necessary steps forward that placed our state in a position to continue to address these critical issues.

Collectively, these three pieces of legislation put additional vital resources in DCYF, our mental health system, the DD community, and our foster care system. These bills include:

• Restoration of Voluntary Services in DCYF • Community Based Prevention Programs in DCYF • State Loan Repayment to healthcare providers • Additional Child Protection Service and Social Workers • Foster Care Rate Increase • Supplemental support for the developmentally disabled waitlist

We are making great strides forward, but more is needed. The solutions contained in these bills reinforce my commitment to ensuring that those most in need of assistance have access to support services. It is my strong hope that this committee and the House of Representatives will join me in supporting them.

Sincerely,

Christopher T. Sununu Governor

107 North Main Street, State House - Rm 208, Concord, New Hampshire 03301 Telephone (603) 271-2121 • FAX (603) 271-7640 Website: http://www.governor.nh.gov/ • Email: [email protected] TDD Access: Relay NH 1-800-735-2964 New Hampshire Legislative Children's Caucus Statement of Position

On April 1, 2018, the NH Legislative Children's Caucus voted to endorse SB 582- authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor. The Children's Caucus' mission is to advocate for effective policy changes to ensure all of New Hampshire's children flourish and reach their fullest potential.

Given our mission, the Children's Caucus voted to endorse this bill for the following reasons: • SB 582 provides for and appropriates funds for an assessment to determine appropriate case load and work load standards for child protection staff • This bill makes appropriations for 13 additional child protection staff and two supervisors • This bill appropriates funds for foster care and adoption programs, services and rate increases

The legislative Children's Caucus encourages these provisions of this legislation to be maintained. 4 Chenell Drive, Suite 103, Concord, NH 03301 603-226.7135 )) nciswnh.org ON A S VV, NEW HAMPSHIRE CHAPTER Notional Assaciation of Social Workers

April 2, 2018

Finance Committee New Hampshire House of Representatives 107 North State Street Concord, NH 03301

Re: Senate Bill 582-Authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protections services position in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor

Dear Mr. Chairman and Members of the Committee,

This letter is to express the National Association of Social Workers New Hampshire Chapter's (NASW NH) support of Senate Bill 582.

Family life cycle challenges of today are multifaceted and multilevel. Child welfare systems are faced with daunting challenges as they endeavor to provide essential services that protect and advance the well- being of children. Effectively serving children and families takes time, relationship building, service coordination and true engagement. All of what makes for a successful intervention and what leads to a positive outcome is time-intensive. Ensuring that social workers and foster care caseworkers have manageable caseloads allows them the time to give each case the attention it deserves

The complexity of families' problems and issues require more time, paperwork, documentation and client contact. With so many families on caseloads investing in developing relationships is difficult.

Staff turnover and high caseloads result in a lack of relationships between workers and families and a limited focus on child safety while also affecting the timeliness of decisions regarding safe and stable placements.

New Hampshire's most valuable asset is the families who live here. New Hampshire lawmakers have an obligation to promote family well-being; as social workers our mission is to work with our legislators to ensure this happens.

Thank you for the opportunity to voice our support.

Respectfully submitted,

Lynn Stanley, LICSW Executive Director NASW NH Testimony re: SB 582

Alexandra Marella

April 3, 2018

Good Afternoon. My name is Alexandra Marella and I am a Child Protective Service Worker for the

Keene DCYF office. I have been with the Division for a little over two years. I am here representing

myself. I love the work I do to ensure the safety of children in New Hampshire. I am a family service

worker, which means that I work long-term with families after a finding of abuse and neglect is made to

ensure there is change and to ensure the safety of the children.

Currently I have 15 cases. In these 15 family services cases, I am working with 15 moms, 17 dads, and 25

children. Of the 15 cases, I have 5 in-home cases with 11 children and 10 out-of-home cases with 14

children. These 14 children are placed in various placements such as residential, relative homes, and foster homes. Currently, to see all of the children on my caseload I have to schedule 16 visits each

month. I have 3 children placed out of state which requires me to be out of the office for a full day and I

have 4 other kids outside of the Keene catchment area. While the remaining 18 kids are in my catchment area, that covers over 35 towns and it takes a half hour, on average, to drive to each visit. In addition to visiting all the children on my caseload each month, I am responsible for writing court reports, attending various school, team, and provider meetings. I could spend all day listing all of the meetings I must attend and paperwork I need to complete.

Due to my high caseload, on average I am working an extra 2-4 hours of comp time every week to be able to complete the work required of me. This does not always include all the necessary paperwork for a case, just the most important items. While I continue to receive comp time, the work on my caseload still needs to be completed, so finding time to take my comp time is not always possible. It is not possible to take comp time as quickly as it accrues. It is difficult to keep up with the rising caseload and ensure the work is done. Being a child protective service worker is not a job you can leave at the door. I

1 personally find it difficult to leave the work "at the door". Many of these children look to their workers for guidance and support, and as a caregiver. While I know this is the job I signed up for, and I do not mind taking some aspects of the job home, I should not have to take home the level of stress I have because of my caseload, thinking of paperwork that was not complete, thinking of ways to manage my time the next day, and so on. I love my job.

My coworkers and I support each other the best we can. Unfortunately, with the amount of time needed for this job, it is difficult to find time for my own family during the week. I hope you understand that I am not in any way complaining of the work I do. I love my job very much. However, as caseloads continue to rise, we are unable to do our jobs effectively. Ultimately, that puts the children of New

Hampshire at risk for continued abuse and neglect. I implore you to pass this bill. We need more workers. But we need more workers than what this bill provides. We need to fully fund and staff CPSW positions and implement caseload standards. As pointed out before, caseload should not just be about the number of families, but the number of children we need to work with to help them be safe. We ultimately need those standards in place so that we can finally have the resources we need to do our jobs.

2 As Amended by the Senate LBAO 18-2894 Amended 3/20/18

SB 582-FN- FISCAL NOTE AS AMENDED BY THE SENATE (AMENDMENT #2018-0990s)

AN ACT authorizing an assessment to determine appropriate caseload and workload standards for the division for children, youth and families; establishing additional child protection services positions in the division for children, youth and families; relative to foster care and adoption programs and services; and making appropriations therefor.

FISCAL IMPACT: [ X State [ ] County [ ] Local [ ] None

Estimated Increase / (Decrease) STATE: FY 2019 FY 2020 FY 2021 FY 2022 Appropriation $2,300,000 $0 $0 $0 Revenue $0 $0 $0 $0 Indeterminable Indeterminable Indeterminable Expenditures $3,136,000 Increase Increase Increase [ X ] General [ ] Education [ ] Highway X ] Other - Funding source: Federal Funds

METHODOLOGY: This bill: 1. Requires the Department of Health and Human Services to conduct an assessment to determine appropriate caseload/workload standards for the Division for Children, Youth, and Families (DCYF), and appropriates $100,000 in FY19 for this purpose; 2. Establishes 13 child protective social worker positions and two supervisor positions within DCYF, and appropriates $1,100,000 for this purpose in FY19; 3. Appropriates $1,100,000 in FY19 for the purpose of funding foster care and adoption programs and services; and 4. Authorizes the transfer of $429,000 in existing general fund appropriations for the purpose of funding foster care rate increases in FY19.

The Department states that the total costs of bullets 2 and 3 above will be $3,036,000 in FY19, but that federal matching funds of $836,000 will supplement the general fund appropriation to cover costs. The Department does not project ongoing costs beyond FY19, but total costs will likely exceed $3,000,000 per year if the positions and foster care services are continued beyond the current FY18/19 budget.

AGENCIES CONTACTED: Department of Health and Human Services

SB 582-FN - AS AMENDED BY THE SENATE - Page 2 - 1 ending June 30, 2019, the sum of $1,100,000 is hereby appropriated to the department of health and 2 human services for the purpose of funding the positions established in section 3 of this act. This 3 appropriation is in addition to any other funds appropriated to the department. The governor is 4 authorized to draw a warrant for said sum out of any money in the treasury not otherwise 5 appropriated. 6 5 Department of Health and Human Services; Appropriation; Foster Care and Adoption 7 Programs and Services. The sum of $1,100,000 for the fiscal year ending June 30, 2019, is hereby 8 appropriated to the department of health and human services for the purpose of funding foster care 9 and adoption programs, rate increases, and services pursuant to RSA 170-G:3. This appropriation 10 is in addition to any other funds appropriated to the department. The governor is authorized to 11 draw a warrant for said sum out of any money in the treasury not otherwise appropriated. 12 6 Effective Date. This act shall take effect upon its passage.

SB 582-FN - AS AMENDED BY THE SENATE 03/14/2018 0990s 03/22/2018 1154s 18-2894 05/10

STATE OF NEW HAMPSHIRE

In the Year of Our Lord Two Thousand Eighteen

Be it Enacted by the Senate and House of Representatiues in General Court convened:

1 1 Department of Health and Human Services; Division for Children, Youth and Families; 2 Assessment to Determine Appropriate Caseload and Workload Standards for Child Protection Staff. 3 The commissioner of the department of health and human services shall conduct an assessment to 4 determine appropriate caseload and/or workload standards for the department's division for 5 children, youth and families' child protection staff that are consistent with the goals of the agency's 6 practice model and that will enable the agency to fulfill its statutory mission to protect children 7 from abuse and neglect. In conducting the assessment, the department may solicit information 8 from experts, community stakeholders, and national leaders, and shall consider caseload trends and 9 the impact of caseloads and workloads on recruitment and retention and the supervision an( 10 training of department staff. On or before January 1, 2019, the department shall report the 11 findings of its assessment, along with the department's recommendations for establishing and 12 maintaining appropriate caseload and/or workload standards and the department's estimate of the 13 cost to implement those recommendations, to the house health, human services and elderly affairs 14 committee and senate health and human services committee and the house and senate finance 15 committees. 16 2 Department of Health and Human Services; Appropriation; Assessment. For the fiscal year 17 ending June 30, 2019, the sum of $100,000 is hereby appropriated to the department of health and 18 human services for the purpose of conducting the assessment under section 1 of this act. This 19 appropriation is in addition to any other funds appropriated to the department. The governor is 20 authorized to draw a warrant for said sum out of any money in the treasury not otherwise 21 appropriated. 22 3 DepartMent of Health and Human Services; Division for Children Youth and Families; 23 Classified Positions Established. The following classified positions are hereby established in the 24 department of health and human services, division for children, youth and families: 25 I. Thirteen child protection social worker I positions, at labor grade 18. 26 II. Two supervisor IV positions, at labor grade 25. 27 4 Department of Health and Human Services; Appropriation; Positions. For the fiscal year SB 582-EN AS AMENDED BY THE SENATE 03/14/2018 0990s 03/22/2018 1154s 2018 SESSION 18-2894 05/10

SENATE BILL 582-FN

SPONSORS: Sen. Carson, Dist 14; Sen. Avard, Dist 12; Sen. Feltes, Dist 15; Sen. Soucy, Dist 18; Rep. M. McCarthy, Hills. 29; Rep. Morrison, Rock. 9; Rep. Bove, Rock. 5; Rep. Guthrie, Rock. 13; Rep. Rosenwald, Hills. 30

COMMITTEE: Health and Human Services

AMENDED ANALYSIS

This bill:

I. Directs the department of health and human services to conduct an assessment to determine appropriate caseload and workload standards for child protection staff and makes an appropriation for such purpose.

H. Makes appropriations to the department of health and human services for additional child protection staff, and for foster care and adoption programs, rate increases, and services.

explanation: Matter added to current law appears in bold italics. Matter removed from current law appears [ Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.