The Louisiana Department of Children and Family Services should scrutinize its spending more, according to the Louisiana Legislative Auditor. (Julie O’Donoghue/Louisiana Illuminator)
The Louisiana Department of Children and Family Services needs to better scrutinize the amount of money it pays to foster care vendors, especially transportation and “sitter” services, according to a recent state review.
Louisiana Legislative Auditor Michael Waguespack released a report Monday that suggests the state agency overseeing adoption and foster care could be overpaying, in part because its online payment system doesn’t flag excessive charges or provide details about the service rendered.
In a response to the audit, the child welfare agency said it is already working to improve its checks and balances, including an upgrade to its payment system to address the auditor’s concerns. Most of the improvements are expected to be in place by the end of November, Children and Family Services Secretary Rebecca Harris, who took over the agency in July, said in an Aug. 15 letter to the auditor.
“DCFS remains committed to continuously evaluating ways to improve and streamline the process within the agency,” Harris wrote.
Over budget years 2021 through 2024, department payments through the child welfare agency’s online system increased far more than the number of clients served. Spending climbed 53% from $80.9 million to $124.1 million over the period, while the total number of people who received services increased 10% from 21,436 to 23,599.
The department attributes these increases to rising day care and foster care costs and more demand for those services. The number of children in day care went from 1,528 to 2,784 per year over the review period, and the cost rose from $3.9 million to $12 million at the same time.
The auditor believed costs could be better controlled in other areas, such as payments for “sitters” paid who watch children in child welfare custody.
Children and Family Services policy sets the hourly rate for in-home sitters at a maximum of $28, but hospital sitters don’t have a maximum. The auditor found the agency paid some hospital sitters as much as $40 per hour – and sometimes paid two hospital sitters for the same client at the same time.
The department also often paid for a hospital sitter when the service was being provided at an office or in a hotel room. Almost a third of the payments made for hospital sitters – $2.2 million in total – were paid out for client services that never involved a hospital stay.
“Coding these payments as hospital sitters rather than in-home sitters could be a way to circumvent the maximum hourly rate set by the in-home sitter policy,” the audit report said.
Children and Family Services also appeared to be paying more than its designated hourly rate for “restrictive staffing,” which is when one-on-one intervention is required for a child. The standard rate for this service is set at a maximum of $16 per hour. But out of 175 payments made for restrictive staffing during this audit review period, more than half may have exceeded the $16 per hour rate, according to the auditor.
The auditor also flagged some payments for transportation services and said the agency should adopt more standard rates for travel.
For example, the auditor questions a $2,100 payment made to a vendor for providing transportation for a child going from their home or the agency office to school and back. The charge was $60 each way for a little over two weeks.
“While this payment went through the required approval process, there is no rate set in policy to ensure the rates are reasonable,” according to the audit.
In some cases, Children and Family Services is also paying far higher reimbursement rates for transportation than Medicaid agrees to cover. In one example, the state agency’s compensation for a 2.5-mile trip within Monroe was $300, while the Medicare reimbursement would have ranged from $19 to $25, according to the auditor.
The auditor suggested the agency could avoid overpayments by requiring higher-level staff members to approve payments made manually and outside of standard rates. Children and Family Services should also set more standard rates for services like “sitting” and transportation.
“Because manual payments only require approval by a supervisor, this process creates a higher risk that payments are approved when they should not be,” according to the audit.
The auditor also said more documentation backing up the reason for payments – such as the amount of hours the service was provided – is needed to ensure reasonable payments are made.
In fiscal year 2024-25, about 56% of the child welfare department’s $327 million budget came from federal funding. The rest was provided by state funding or money the department generates itself.
