State licensure officials barred an embattled Kansas contractor from caring for any new Omaha-area children and families for 60 days starting on Friday.
The Department of Health and Human Services Public Health Division imposed the restriction Thursday along with granting St. Francis Ministries a probationary license as a child placing agency.
In the meantime, any new child welfare cases in Douglas and Sarpy counties will be handled by state child welfare workers, according to an HHS release. The department will deploy existing staff to manage the cases, while hiring additional workers.
HHS officials said that “while St. Francis has shown improvement in key areas, the decision to restrict new referrals is the best course of action right now to allow (St. Francis) the time to work with (the department) to correct deficiencies and build appropriate staff.”
“I have seen this work in other states over the course of my career. This is a way for DHHS to augment St. Francis’ resources,” said HHS CEO Dannette Smith.
St. Francis Ministries, a nonprofit based in Salina, Kansas, holds a multimillion-dollar contract with HHS to manage the care of abused and neglected children in the two-county area. The contract and St. Francis’ performance under it are the focus of a legislative investigation.
The agency has yet to comply with key requirements of its contract, including the caseload limits for workers set by state law. The contract was signed in July 2019 and took effect in January 2020.
In addition, state health inspectors put St. Francis’ license as a child placing agency on probation in May after the nonprofit failed an inspection in September 2020 and, despite repeated opportunities, had not corrected its problems by mid-April. HHS initially gave St. Francis until Aug. 1 to correct its deficiencies, then extended the deadline to Sept. 30.
Thursday’s action keeps the probationary license in place for another 60 days but adds the restriction on accepting new cases. St. Francis has 15 days to appeal the decision.
Losing the child placing agency license would prevent St. Francis from carrying out a core part of its contract — placing children in foster or adoptive homes.
St. Francis leaders pledged Thursday to work with HHS, local care providers and others during the probationary period to ensure they address the areas needing improvement to maintain its child-placing agency license.
In a statement, a St. Francis spokeswoman said that agency staff “care deeply about the health and well-being of all the children and families we serve, and we will adapt processes, train for continuous improvement, and take guidance from (the department) with the goal of doing the best work possible.”
“No one goes into this field without the best interests of children and families in the forefront of their mind,” said William Clark, interim CEO of St. Francis. “We have made significant strides forward, and I am confident we will meet the expectations of (the department).”
Sen. John Arch of La Vista, who chairs the investigative committee, said he had not seen the licensure report but was pleased that HHS officials were taking action if they believed action was needed.
Sen. Machaela Cavanaugh of Omaha, who introduced the resolution to launch the investigation, said the licensure restriction “seems to be a significant step and probably appropriate based on the Inspector General’s report.”
That report, issued last week by Jennifer Carter, inspector general of Nebraska child welfare, called for the state to terminate its contract with St. Francis and end its 12-year experiment with having private entities manage child welfare cases.
St. Francis won the Nebraska contract by offering to do the job for $197 million over five years, less than 60% of the bid from PromiseShip, the Omaha-based contractor that had managed child welfare cases for nearly a decade.
However, Nebraska signed a new, emergency contract with St. Francis in late January that erased the difference in cost between the two bids. HHS officials signed the contract after Clark said the nonprofit would run out of money to operate unless Nebraska agreed to pay more.
The 25-month, $147.3 million emergency contract ends Feb. 28, 2023, a month after Gov. Pete Ricketts is term-limited out of office. State officials have not said what they plan to do after that date. Under state law, the contract could be extended for another year.
But rebidding the contract or returning case management responsibility to state workers, as it is in the rest of the state, would require months of lead time to allow for a gradual transition of cases and potentially go through the lengthy bidding process.
The future of Nebraska child welfare privatization is one of the key questions to be answered by the legislative investigation.
The investigative committee and the Health and Human Services Committee plan a hearing Oct. 8 to hear from HHS and the State Department of Administrative Services, which handles contracting.
St. Francis officials also have been asked to appear. In an effort to ensure they show up and bring requested documents, the committee last week authorized the issuance of a subpoena.