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CDSS TIERED FOSTER CARE RATE STRUCTURE RESOURCES
Implementation target date: July 1, 2027* See below for highlights from:
*CA state budget: Likely trigger provision: Implementation will be based on availability of CA General Fund in spring 2027. Delays possible.
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California is restructuring our rates so that they are based on the child’s assessed level of needs and strengths, and not based on the placement type. RELATED: CDSS CFT AND CA IP-CANS CDSS adopted the CA Integrated Practice (IP) CANS as the functional assessment tool to be used within Child & Family Team (CFT) processes (ACL NO. 18-81, July 2018) | CDSS IP-CANS Resources See CDSS Child and Family Teams & Integrated Practice-Child and Adolescent Needs and Strengths 2025 (May 2025) for a summary of updated requirements | ACL 25-08 & ACL 25-10 |
Improving Outcomes for Children and Families in California’s Foster Care System, Permanent Rate Structure | The Tiered Foster Care Rate Structure Summary (July 2024) | Includes Rate Structure Framework & Case Examples
... When implementation of the Continuum of Care Reform (CCR) began in 2017, an interim foster care rate structure was created, which included a level of care system for children in family settings and a separate rate structure for those in congregate settings. However, statute required California to establish an ongoing payment structure. The 2024-25 Budget included the permanent foster care rate structure, known as the Tiered Rate Structure. ...
... California is restructuring our rates so that they are based on the child’s assessed level of needs and strengths, and not based on the placement type. Additionally, under the Tiered Rate Structure, every child in foster care will receive funding that they will direct towards strength building activities. Further, youth with identified urgent needs will also receive funding to support needed services and interventions, which will be available across any placement setting, including a youth’s own relatives or extended family members. ...
... The data from the CANS can be aggregated and analyzed through an approach known as a Latent Class Analysis (LCA). ... The permanent rate structure is based on a child's identified needs and strengths as identified by the CANS assessment. ...
... The permanent rate structure advances equity in California’s Child Welfare system by strengthening our kin-first approach, keeping families together, and by putting services in place based on the child’s CANS assessment and needs, not based on their placement... (more)
... When implementation of the Continuum of Care Reform (CCR) began in 2017, an interim foster care rate structure was created, which included a level of care system for children in family settings and a separate rate structure for those in congregate settings. However, statute required California to establish an ongoing payment structure. The 2024-25 Budget included the permanent foster care rate structure, known as the Tiered Rate Structure. ...
... California is restructuring our rates so that they are based on the child’s assessed level of needs and strengths, and not based on the placement type. Additionally, under the Tiered Rate Structure, every child in foster care will receive funding that they will direct towards strength building activities. Further, youth with identified urgent needs will also receive funding to support needed services and interventions, which will be available across any placement setting, including a youth’s own relatives or extended family members. ...
... The data from the CANS can be aggregated and analyzed through an approach known as a Latent Class Analysis (LCA). ... The permanent rate structure is based on a child's identified needs and strengths as identified by the CANS assessment. ...
... The permanent rate structure advances equity in California’s Child Welfare system by strengthening our kin-first approach, keeping families together, and by putting services in place based on the child’s CANS assessment and needs, not based on their placement... (more)
To learn more about the new Permanent Rate Structure, please visit the CDSS website.
Also see CDSS IP-CANS Resources.
Also see CDSS IP-CANS Resources.
The Permanent Foster Care Rate Structure: Implementation Overview Webinar | The Tiered Foster Care Rate Structure Implementation Overview Webinar (October 2024) | Full Transcript
[Stakeholder workgroups] ... four rates subgroups were established ... resource homes, ISFC, STRTPs and FFAs. Each of those four subgroups met five times each from August to November of 2022. ... themes across all four of the work groups were that rates needed to account for services and supports as well as care and supervision. That the rate should follow the child and not the placement type. That the assessment should identify the child's level of need, not where the child should be placed, and that the current rates are inadequate across all placement settings. ... culturally responsive services should be made available for Indian children and families. ... So with that feedback in hand, we used that to inform the proposal that was then developed throughout 2023. ... ... All the rates are based on the needs of the child and intended to support the child in whichever placement they will do best. And often that's the home of relatives. ... ... broken down the implementation...into five key categories ... CFT and CANS fidelity ... care and supervision ... strengths building program ... immediate needs program ... automation of the permanent rate structure within CalSAWS and CWS-CARES ... |
... preparation phase, which will start in July of 2025 and go until June of 2026 ... ... fidelity of the CANS is related to fidelity of the child and family team and child and family team meetings to really make sure that voices and any individuals who have information and connection to that child and that family are part of the CFT meetings that are ultimately informing the CANS. ... multiple voices, inter-rater reliability ... ... a series of work groups have contributed to the development and guidance and standards for the Integrated Practice CANS both in terms of the policy changes that align with the foster care rate structure. statute and fidelity requirements. ... ... from October 2026 through June 2027, the department will conduct the necessary trainings and webinars and overviews ahead of the permanent foster care rate structure. ... |
To learn more about the new Permanent Rate Structure, please visit the CDSS website.
Also see CDSS IP-CANS Resources.
Also see CDSS IP-CANS Resources.
The Child and Adolescent Needs and Strengths (CANS) Tool, Latent Class Analysis (LCA), and Decision Support Model (DSM) Overview Webinar | CDSS and the University of Kentucky's Center for Innovation in Population Health (IPH) CANS, LCA, and DSM Overview Webinar (May 2024) | Full Transcript
... within that CFT, the CANS can do what it really does best: organize, prioritize, and highlight people's strengths and needs and help to create an environment where identifying supports and tracking change is a collaborative effort. ... ... intentional about reliability with the CANS and so it really starts with the training where people have to train to a reliability of .70 or higher, the average reliability in California is over .78, so it's really pretty robust. ... it's actually one of the few metrics that the field reliability has been established to be higher than the training reliability because if you, if it matters, then people take it seriously. ... ... what LCA does, it's a statistical procedure that allows you to identify groupings of kids who are more like each other than they're like other kids. ... what we discovered is that there were four different neighborhoods, if you will, within the 0-5 [age group] and seven different neighborhoods within the 6+ [age group]. [These are represented within three tiers. See slide snapshots 1-4 below for an overview of the Decision Support Model (DSM) for ages 6+ and slide 5: How the CANS, the LCA, and the DSM Inform the Tiered Rate Structure] |
... The first CANS will determine their tier upon entry into the system, and that has to happen within the first 60 days that a child is in care. So pending the completion of the CANS, the proposed rate structure proposes that youth would start at a level of funding equivalent to the care and supervision component of tier two. ... ... what is the process by which we would move the child up and down into the corresponding tier ... we want to titrate down slowly for kids that are in family placements because we don't want to destabilize those placements and you'd want to titrate up quickly in order to make sure that kids have the appropriate support that they need ... ... we have tried to create a system that is very individualized so that those strength building dollars are attached to the child and the immediate needs dollars are attached to the child to allow for that individualization that we know is necessary ... |
To learn more about the new Permanent Rate Structure, please visit the CDSS website.
Also see CDSS IP-CANS Resources.
Also see CDSS IP-CANS Resources.
Improving Outcomes for Children and Families in California’s Foster Care System, Proposed Permanent Rates Structure, Frequently Asked Questions | CDSS Foster Care Rate Reform FAQ Document (April 2024) | Includes Strengths Building and Immediate Needs Examples
... 4. Why is this proposal utilizing CANS to determine the child’s tier?
Response: The CANS is a validated functional assessment tool that is used to support care planning and level of care decision-making, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services.
The CANS gathers information from individuals important to the child based on domains that focus on various areas in a child’s life. There are domains that address how the child functions in everyday life, on specific emotional or behavioral concerns, on risk behaviors, on strengths and on skills needed to grow and develop. A certified CANS facilitator develops a rating for each of these items based on input from the people who are important to the child (including the child). These ratings help the placing agency, provider, child and family understand where intensive or immediate action is most needed. ...
... 6. What other states have structured their rates this way?
Response: California would be the first state in the nation to have a rate structure based exclusively on the needs of the child and not tied to the child’s placement type. In addition, California would be the first state in the nation to invest in this way in strengths building and immediate needs within the foster care rates structure. ...
... 12. What are examples of strengths building? ...
... 13. What are some examples of immediate needs? ...
... 4. Why is this proposal utilizing CANS to determine the child’s tier?
Response: The CANS is a validated functional assessment tool that is used to support care planning and level of care decision-making, to facilitate quality improvement initiatives, and to allow for the monitoring of outcomes of services.
The CANS gathers information from individuals important to the child based on domains that focus on various areas in a child’s life. There are domains that address how the child functions in everyday life, on specific emotional or behavioral concerns, on risk behaviors, on strengths and on skills needed to grow and develop. A certified CANS facilitator develops a rating for each of these items based on input from the people who are important to the child (including the child). These ratings help the placing agency, provider, child and family understand where intensive or immediate action is most needed. ...
... 6. What other states have structured their rates this way?
Response: California would be the first state in the nation to have a rate structure based exclusively on the needs of the child and not tied to the child’s placement type. In addition, California would be the first state in the nation to invest in this way in strengths building and immediate needs within the foster care rates structure. ...
... 12. What are examples of strengths building? ...
... 13. What are some examples of immediate needs? ...
... 18. What will the accountability be and how will we know outcomes are improving?
Response: The CDSS will audit to make sure dollars are being utilized in a capacity that is consistent with the needs of the child. The CDSS will also adopt the CANS fidelity tools developed by the Center for Innovation in Population Health (IPH), the developer of the CANS, to make sure the CANS is being administered to fidelity and to make sure spending plans are reflective of the needs and strengths identified in the CANS.
19. What is the accountability available to a family/child to make sure the resources are being directed towards the identified strength building and immediate needs consistent with the child’s CANS assessment?
Response: In addition to the adoption of the CANS fidelity tools to make sure the CANS is being administered to fidelity and to make sure case plans are reflective of the needs and strengths identified in the CANS, the strengths building and immediate needs dollars will be structured in the following ways to create a high level of accountability.
Immediate Needs
a. The CDSS will establish Model Standards for each tier and will provide contracts requirements.
b. Placing agencies will submit a county plan demonstrating full compliance with the Model Standards for each tier. Contracted providers of the placing agency also must provide documentation demonstrating full compliance.
c. The CDSS will review and approve the county plans for each tier.
d. The placing agency will then implement their network utilizing FFAs, STRTPs, MHPs, and/or CBOs for the delivery of services.
e. The CDSS will conduct audits to make sure counties and providers are delivering services that adhere to the standards established.
f. The CDSS and IPH (the developer of the CANS) will implement an ongoing CQI [Continuous Quality Improvement] framework to inform updating of standards, human-centered process improvements and improve overall quality of care.
Strength Building Dollars
a. A child or youth is assigned into a respective tier based on their CANS score.
b. A child’s individual budget is set based upon amount allotted for that tier (Tier 1 -$500, Tier 2 -$700, or Tier 3 - $900).
c. The child, caregiver, etc. develop a strengths building spending plan based upon the CANS assessment, the child’s interests, etc.
d. The CFT supports the family in selecting goods, services, activities and supports consistent with the strength building objectives identified by the CANS.
e. The child and family work with their Financial Management Coordinator (a CDSS contractor) to pay for and, if needed, otherwise procure the goods, services, activities and supports for the child consistent with the spending plan. (more)
To learn more about the new Permanent Rate Structure, please visit the CDSS website.
Also see CDSS IP-CANS Resources.
Response: The CDSS will audit to make sure dollars are being utilized in a capacity that is consistent with the needs of the child. The CDSS will also adopt the CANS fidelity tools developed by the Center for Innovation in Population Health (IPH), the developer of the CANS, to make sure the CANS is being administered to fidelity and to make sure spending plans are reflective of the needs and strengths identified in the CANS.
19. What is the accountability available to a family/child to make sure the resources are being directed towards the identified strength building and immediate needs consistent with the child’s CANS assessment?
Response: In addition to the adoption of the CANS fidelity tools to make sure the CANS is being administered to fidelity and to make sure case plans are reflective of the needs and strengths identified in the CANS, the strengths building and immediate needs dollars will be structured in the following ways to create a high level of accountability.
Immediate Needs
a. The CDSS will establish Model Standards for each tier and will provide contracts requirements.
b. Placing agencies will submit a county plan demonstrating full compliance with the Model Standards for each tier. Contracted providers of the placing agency also must provide documentation demonstrating full compliance.
c. The CDSS will review and approve the county plans for each tier.
d. The placing agency will then implement their network utilizing FFAs, STRTPs, MHPs, and/or CBOs for the delivery of services.
e. The CDSS will conduct audits to make sure counties and providers are delivering services that adhere to the standards established.
f. The CDSS and IPH (the developer of the CANS) will implement an ongoing CQI [Continuous Quality Improvement] framework to inform updating of standards, human-centered process improvements and improve overall quality of care.
Strength Building Dollars
a. A child or youth is assigned into a respective tier based on their CANS score.
b. A child’s individual budget is set based upon amount allotted for that tier (Tier 1 -$500, Tier 2 -$700, or Tier 3 - $900).
c. The child, caregiver, etc. develop a strengths building spending plan based upon the CANS assessment, the child’s interests, etc.
d. The CFT supports the family in selecting goods, services, activities and supports consistent with the strength building objectives identified by the CANS.
e. The child and family work with their Financial Management Coordinator (a CDSS contractor) to pay for and, if needed, otherwise procure the goods, services, activities and supports for the child consistent with the spending plan. (more)
To learn more about the new Permanent Rate Structure, please visit the CDSS website.
Also see CDSS IP-CANS Resources.
