Performance Audit, Homeless Youth Intervention Program

              State of Arizona
Office
of the
Auditor General
PERFORMANCE AUDIT
Report to the Arizona Legislature
By Debra K. Davenport
Auditor General
HOMELESS YOUTH
INTERVENTION
PROGRAM
November 2001
Report No. 01-32
The Auditor General is appointed by the Joint Legislative Audit Committee, a bipartisan committee
composed of five senators and five representatives. Her mission is to provide independent and impar-tial
information and specific recommendations to improve the operations of state and local government
entities. To this end, she provides financial audits and accounting services to the state and political
subdivisions and performance audits of state agencies and the programs they administer.
The Joint Legislative Audit Committee
Senator Ken Bennett, Chairman
Representative Roberta L. Voss, Vice-Chairman
Senator Herb Guenther Representative Robert Blendu
Senator Dean Martin Representative Gabrielle Giffords
Senator Peter Rios Representative Barbara Leff
Senator Tom Smith Representative James Sedillo
Senator Randall Gnant (ex-officio) Representative James Weiers (ex-officio)
Audit Staff
Carol Cullen—Manager
and Contact Person (602) 553-0333
Jeffrey Kleist—Team Leader
Tara Lennon—Team Member
Copies of the Auditor General’s reports are free.
You may request them by contacting us at:
Office of the Auditor General
2910 N. 44th Street, Suite 410
Phoenix, AZ 85018
(602) 553-0333
Additionally, many of our reports can be found in electronic format at:
www.auditorgen.state.az.us
2910 NORTH 44th STREET • SUITE 410 • PHOENIX, ARIZONA 85018 • (602) 553-0333 • FAX (602) 553-0051
DEBRA K. DAVENPORT, CPA
AUDITOR GENERAL
STATE OF ARIZONA
OFFICE OF THE
AUDITOR GENERAL
WILLIAM THOMSON
DEPU TY AUDITOR GENERAL
November 15, 2001
Members of the Arizona Legislature
The Honorable Jane Dee Hull, Governor
Mr. John L. Clayton, Director
Department of Economic Security
Transmitted herewith is a report of the Auditor General, An Evaluation of the Homeless
Youth Intervention Program. This evaluation was conducted pursuant to Laws 1999, Ch. 328,
§1(D). I am also transmitting with this report a copy of the Report Highlights for this
evaluation to provide a quick summary for your convenience.
As outlined in its response, the Department of Economic Security agrees with the findings
and recommendations.
My staff and I will be pleased to discuss or clarify items in the report.
This report will be released to the public on November 16, 2001.
Sincerely,
Debra K. Davenport
Auditor General
Enclosure
i
OFFICE OF THE AUDITOR GENERAL
SUMMARY
The Office of the Auditor General has completed an evaluation
of the Homeless Youth Intervention Program (program) admin-istered
by the Arizona Department of Economic Security (DES).
The evaluation was conducted pursuant to Laws 1999, Ch. 328,
§1(D).
The program’s goal is to reunify homeless youth with their fami-lies.
It facilitates the reunification process by providing services
and working with youths and families to improve parent-child
relationships. When reunification is not possible, the program
then works to enhance the youth’s ability to become self-sufficient.
The Arizona Department of Economic Security administers the
program. The Legislature appropriated $800,000 for its first 18
months of operation, from January 1, 2000 through June 30, 2001,
and $400,000 for fiscal year 2002 program operations. DES con-tracted
with the Tumbleweed Center for Youth Development to
operate the program. Tumbleweed provides services through
one site in Maricopa County, and oversees two subcontractors
who provide services through two sites in Pima County and one
site in Yavapai County. The program provides youths with ser-vices
in three phases: referral, assessment, and service plan; and
receives capitated payments for each phase.
Program Should Work
To Increase Youths’ Focus
on Reunification or
Self-Sufficiency
(See pages 13 through 23)
Even though half of the program’s youths were reunified with
their families or on the path to self-sufficiency at case closure, this
does not mean they are now living in a stable situation. These
Summary
ii
OFFICE OF THE AUDITOR GENERAL
youths often enter the program while living in volatile environ-ments
that frequently involve serious, long-term problems.
Therefore, when they leave the program, many youths return to
a living situation that is still unstable. For example, one girl who
had repeatedly run away from her grandmother’s home was re-unified
with her grandmother after a week in the program.
However, neither she nor her grandmother appeared for sched-uled
counseling services and 3 weeks later, the girl again ran
away. Over half of the program youths who reunited with their
families, and half of the youths who appeared to be on the path
to self-sufficiency, were living in an unstable situation or in a
situation in which the stability is unknown. The program needs
to systematically track youths after they leave to measure the
program’s impact on their lives in critical areas, such as the
youth’s living situation, family relations, and ability to live inde-pendently.
While the program has collected follow-up informa-tion
for some youths, it has not done so consistently.
Although many youths who leave the program return to unsta-ble
living conditions, a majority do complete some of the goals
they set while in the program. However, most of the completed
goals are designed to meet basic needs, such as shelter/housing
or providing cash assistance for food. Youths complete fewer
goals related to reunifying with their families or becoming self-sufficient.
Further, the service plans’ goals and tasks developed
under the program often fail to address critical behavioral issues,
such as substance use treatment or mental health problems. Even
though two-thirds of the youths reported current or past alcohol
and/or other drug use and more than one-third reported mental
health problems, only 6 of 223 goals youths set were related to
these issues. For example, one youth with mental health and
substance use problems had only one goal, which addressed ba-sic
needs but not mental health or substance use problems. The
program should assist youths in developing goals that address
critical behavioral needs and help them see the connection be-tween
addressing such needs and achieving reunification or self-sufficiency
goals.
In addition, even though most youths identified family relation-ships
as their main stressor in life, family members were rarely
involved in the development and completion of service plan
Summary
iii
OFFICE OF THE AUDITOR GENERAL
goals. Only 25 percent of the tasks youth identified as part of
their reunification goals involved family members, and only 6 of
36 case files evaluators reviewed included a family assessment.
The program should increase efforts to involve the family in the
assessment and service plan phases.
DES Should Monitor
Program Costs
(See pages 25 through 30)
DES needs to monitor program costs related to the capitated
rates and housing costs. First, although the capitated rate for the
referral phase approximates the actual costs incurred, the capi-tated
rates paid for the assessment and service plan phases are
higher than actual average costs. Specifically, the capitated rate
for the assessment phase is 267 percent, or $160 higher, than the
average cost to perform the assessment. Further, the capitated
rate for the service plan phase is 15 percent, or $423, higher than
the average cost of services. The initial rates were based on the
estimated costs from Tumbleweed, the program contractor. DES
has since renewed Tumbleweed’s contract through June 30, 2002,
and anticipates that it will renew it one additional year. DES
should monitor program costs so that it can ensure that the capi-tated
rates more closely match actual costs in future contracts.
Although the program is able to serve all youths who enter it
now, high housing costs for a few more youths could hinder the
program from serving additional clients. More than 80 percent of
the program’s expenditures are for housing, and most of this
money has been spent to house 12 youths. These 12 youths were
in shelter care and/or transitional living for an average of 108
days each and accounted for over 56 percent of all of the monies
spent during the service plan phase. While other homeless youth
programs strictly limit the length of time they will support
youths in shelters, this program has the flexibility to support its
clients for longer periods.
Summary
iv
OFFICE OF THE AUDITOR GENERAL
However, to ensure that the program can help as many youths
as possible, DES needs to consider policies that control housing
costs, such as limiting shelter care and transitional living stays
based on reviews of youths’ progress while they are in the pro-gram.
v
OFFICE OF THE AUDITOR GENERAL
TABLE OF CONTENTS
Page
Introduction and Background.......................... 1
Finding I: Program Should Work
To Increase Youths’ Focus
on Reunification or Self-Sufficiency ........... 13
Half of Youths Reunified
or on Path to Self-Sufficiency.......................................... 13
Nearly Half of Youth
in Unstable or Unknown
Living Situations at Closure............................................ 14
Youths Primarily Complete
Goals That Meet Basic Needs ......................................... 19
Recommendations .......................................................... 23
Finding II: DES Should Monitor
Program Costs.............................................. 25
Some Capitated Rates
Exceed Actual Costs........................................................ 25
Program Should Monitor
Housing Costs................................................................. 27
Recommendations .......................................................... 30
Agency Response
Table of Contents
vi
OFFICE OF THE AUDITOR GENERAL
TABLE OF CONTENTS (Cont’d)
Page
Tables
Table 1 Homeless Youth Intervention Program
Arizona Department of Economic Security
Schedule of Program Appropriations,
Expenditures, and Carryforward Balances
Years Ended or Ending June 30, 2000,
2001, and 2002
(Unaudited)..................................................... 6
Table 2 Homeless Youth Intervention Program
Tumbleweed Center for Youth Development
Schedule of Program Revenues and Expenses
Years Ended June 30, 2000 and 2001
(Unaudited)..................................................... 7
Table 3 Homeless Youth Intervention Program
Youth Stability at Case Closure
February 1, 2000 through April 30, 2001........ 15
Table 4 Homeless Youth Intervention Program
Comparison of Capitated Rates to
Average Actual Costs
February 1, 2000 through April 30, 2001........ 26
Figures
Figure 1 Homeless Youth Intervention Program
Program Referral, Assessment, and
Service Plan Phases
February 1, 2000 through April 30, 2001........ 8
Figure 2 Homeless Youth Intervention Program
Reported Rates of Prior Abuse
February 1, 2000 through April 30, 2001........ 9
Figure 3 Homeless Youth Intervention Program
Youth Status at Case Closure
February 1, 2001 through April 30, 2001........ 14
Table of Contents
vii
OFFICE OF THE AUDITOR GENERAL
TABLE OF CONTENTS (Concl’d)
Page
Figures (Concl’d)
Figure 4 Homeless Youth Intervention Program
Service Plan Goal Completion Rates
February 1, 2000 through April 30, 2001...... 20
Figure 5 Homeless Youth Intervention Program
Service Plan Phase Costs by Type of Service
February 1, 2000 through April 30, 2001...... 28
viii
OFFICE OF THE AUDITOR GENERAL
(This Page Intentionally Left Blank)
1
OFFICE OF THE AUDITOR GENERAL
INTRODUCTION AND BACKGROUND
The Office of the Auditor General has completed an evaluation
of the Homeless Youth Intervention Program (program) admin-istered
by the Arizona Department of Economic Security (DES).
The evaluation was conducted pursuant to Laws 1999, Ch. 328,
§1(D).
Program Established to
Serve the Needs of Homeless
Youths and their Families
The Homeless Youth Intervention Program was established by
the Legislature to serve Arizona’s homeless youth who are not
currently served by Child Protective Services (CPS) or the juve-nile
justice system. According to a 2000 DES report on the status
of homeless youth, approximately 3,250 youths under 18 were
served by homeless youth programs. However, almost 1,000
youths who sought services did not receive them because exist-ing
programs lacked sufficient capacity or ability to serve youths’
behavioral needs.
In its first 15 months of existence, the program served 94 youths.1
The typical client was a 16- to 17-year-old White female. Many
reported being victims of some form of abuse (physical, sexual,
and/or emotional), came from families with alcohol and/or
other drug use problems, and often had substance use problems
of their own. In over 70 percent of the cases, the youth was either
a runaway or had been kicked out of the home.
1 As seen in Figure 1 (see page 8), between February 1, 2000 and April 30,
2001, the program received 151 referrals, assessed 105 youths, and devel-oped
and closed service plans for 94.
Introduction and Background
2
OFFICE OF THE AUDITOR GENERAL
The program’s goal and objectives
are as follows:
Goal: Reunify homeless youth with their families.
Objective 1: To enhance the parent-child relationship by providing the
necessary resources and services to enable a safe and stable
environment for family reunification.
Objective 2: To increase youths’ ability to be self-sufficient.
Program Provides
a Continuum of Services
to Eligible Youths
The program provides a variety of services to meet the diverse
needs of the homeless youth population. Specifically, these ser-vices
include:
n Family reunification/preservation—Activities, such as fam-ily
counseling, provided to youths and their families in order
to stabilize (preserve) the family or safely facilitate reunifica-tion.
n Case management—Regular one-on-one counseling with
each youth at least once a week.
n Emergency supplies—Medical care and items necessary for
daily living, such as food and clothing.
n Shelter care—Youths are provided a place to live where ba-sic
needs, such as food and clothing, are met. In addition,
youths receive training in living and employment skills, as
well as character education and counseling.
n Employment training—Education on and assistance in ob-taining
and maintaining employment. For example, the pro-gram
provides one-on-one and group assistance in resume
and job interview preparation.
Introduction and Background
3
OFFICE OF THE AUDITOR GENERAL
n Transitional/independent living program—Youths are
placed in supervised apartment living and receive training in
living and employment skills, as well as character education
and counseling.
The program delivers services and programs based on the Youth
Development Approach (YDA), which focuses on providing
youths with the services and support needed to make a success-ful
transition into adulthood. For example, many homeless
youth come to the program with an immediate need for shelter,
food, and clothing. Once these needs
have been met, many of them pur-sue
education and employment
skills. By providing a continuum of
services, the program meets the
youth’s needs within a community
setting and offers participants the
opportunity to learn basic skills, set
service plan goals, participate in
program activities and services that
enable them to take control of their
futures, and successfully make the
transition to adulthood. The program also provides families the
resources needed to support young people, strengthen family
ties, and enhance family functioning.
The program provides services to youths who meet eligibility
criteria. Specifically, Laws 1999, Chapter 328 states that services
can only be provided to youths who are not currently served by
either Child Protective Services or the juvenile justice system, are
under the age of 18, and are considered homeless. DES provides
the following three definitions of homeless youth:
n Homeless—Youth and/or their families lack a permanent
nighttime residence.
n Runaway—Youth has left home overnight without permis-sion
from parents or guardians.
n At Risk—Youth is at imminent risk of leaving or being
thrown out of the family residence.
Youth Development
Approach (YDA)
Is based on the premise
that a youth cannot be
coerced into receiving a
service or addressing a
specific problem area.
Rather, the youth decides
what, if anything, he or
she needs and wants.
Introduction and Background
4
OFFICE OF THE AUDITOR GENERAL
In addition, the youths and their parents/guardians must con-sent
to participate in the program. However, family members do
not have to participate in order for the youth to receive services.
Program Administration
and Budget
DES administers the program. The Legislature appropriated
$800,000 for its first 18 months of operation, from January 1, 2000
through June 30, 2001. Further, the Legislature appropriated an
additional $400,000 for fiscal year 2002 program operations. Ta-ble
1 (see page 6) shows the program awards and expenditures
for fiscal years 2000 through 2002.
On January 11, 2000, the Department contracted with Tumble-weed
Center for Youth Development, at which time program
development was initiated. On February 1, 2000, the program
started accepting referrals. Tumbleweed provides services
through one site in Maricopa County, and oversees two subcon-tractors
who provide services through two sites in Pima County
and one site in Yavapai County. Table 2 (see page 7) shows
Tumbleweed’s expenditures.
Program Provides Services
and Receives Payment in Phases
The program provides youths with services in three phases and
receives capitated payments for each phase. In the referral phase,
the youth is referred to the program, screened for eligibility by
DES and, if eligible, is contacted by a program case manager. If
the youth and his/her parents or guardians consent to the
youth’s participation, the youth moves to the assessment phase.
In this phase, the case manager and youth discuss the youth’s
current living situation, family relationships, and various mental
and behavioral health concerns. Following the assessment, the
case manager meets with the youth and/or family members to
develop the service plan. In this phase, the program provides
services to assist in keeping or reuniting the youth with family,
or enabling the youth to become self-sufficient. Services may in-clude
temporary shelter and transitional living placement, family
Homeless youth were
served in Maricopa, Pima,
and Yavapai Counties.
Introduction and Background
5
OFFICE OF THE AUDITOR GENERAL
support and stabilization, 24-hour crisis services, independent
living skills, character education, and job training. Many of these
services are provided by case managers who also meet with the
youth on a regular basis to record completion of tasks and goals
and to revise the service plan as needed. Figure 1 (see page 8)
shows the descriptions of each phase, the number of youths who
participate in each phase, and the number of youths whose cases
were closed at each phase.
DES allocates program monies to Tumbleweed for each youth
served, depending on the phase(s) of service provided. Tumble-weed
receives $50 for each youth referral, $250 for each youth
assessment completed by a case manager, and $3,600 for services
prescribed in the youth’s service plan. Tumbleweed withholds
12 percent of these capitated fees for administrative expenses,
such as staff salaries and office equipment.1 The remaining mon-ies
are used to provide services to the youths enrolled in the pro-gram,
including case management.
As seen in Figure 1 (see page 8), between February 1, 2000 and
April 30, 2001, the program received 151 referrals, assessed 105
youths, and developed and closed service plans for 94.
Program Participant
Demographics
After reviewing the demographic and background information
for the 94 youths who had service plans closed before May 1,
2001, evaluators found that 66 percent of the youth were be-tween
16 and 17 years old, 69 percent were female, and 61 per-cent
were White (20 percent were Latino, 13 percent were Black,
and 6 percent were Asian, Native American, or other). In addi-tion,
youths reported the following problems at intake:
n Twenty-eight percent were at risk of being homeless, 32 per-cent
were runaways, and 40 percent were homeless, kicked
out of the home, or taken to the program by family members.
1 With the 12 percent administrative fee withheld, capitated payments are:
referral—$44, assessment—$220, and service plan—$3,168.
Introduction and Background
6
OFFICE OF THE AUDITOR GENERAL
Table 1
Homeless Youth Intervention Program
Arizona Department of Economic Security
Schedule of Program Appropriations, Expenditures, and Carryforward Balances
Years Ended or Ending June 30, 2000, 2001, and 2002
(Unaudited)
20001
(Actual)
2001
(Actual)
2002
(Estimated)
Temporary Assistance for Needy Families Block Grant
Appropriations 2 $400,000 $400,000 $400,000
Contract services expenditures 3 173,300 570,000 456,700
Excess of appropriations over (under) expenditures 226,700 (170,000) (56,700)
Carryforward balance, beginning of year 226,700 56,700
Carryforward balance, end of year $226,700 $ 56,700 $ 0
1 The Homeless Youth Intervention Program started accepting referrals February 1, 2000; therefore, the 2000
financial activity is for only 5 months of the fiscal year.
2 The 2000 and 2001 appropriations are exempt from A.R.S. §35-190, relating to the lapsing of appropriations;
however, any remaining 2002 appropriations lapse.
3 Amount is payment to Tumbleweed Center for Youth Development for contracted services. These payments
include a 12 percent administrative costs allowance. See Table 2 (page 6) for certain financial information of
the Center.
Source: Auditor General staff analysis of the State of Arizona Appropriations Report and various reports of the
Arizona Department of Economic Security Financial Management Control System for the year ended
June 30, 2000 and 2001; and Department of Economic Security estimates of financial activity for the year
ended June 30, 2002.
Introduction and Background
7
OFFICE OF THE AUDITOR GENERAL
Table 2
Homeless Youth Intervention Program
Tumbleweed Center for Youth Development
Schedule of Program Revenues and Expenses
Years Ended June 30, 2000 and 2001
(Unaudited)
2000 1 2001
Revenues:
Department of Economic Security reimbursements $173,300 $570,000
Expenses:
Personal services 15,834 63,203
Employee-related 2,604 11,178
Other operating 2 12,415 53,077
Shelter care 3 49,588 149,090
Contractor payments 4 85,723 261,016
Total expenses 166,164 537,564
Excess of revenues over expenses $ 7,136 $ 32,436
1 The 2000 amounts are for only 5 months of the fiscal year because the Homeless Youth Intervention
Program did not begin accepting referrals until February 1, 2000.
2 Includes rent, utilities, client-related materials and supplies, office-related equipment and supplies,
printing, telephone, training, insurance costs, and general administrative costs.
3 The amount represents the Center’s charges for providing shelter care.
4 Amounts paid to other providers for services outside the Center’s service area, primarily for shelter
care.
Source: Auditor General analysis of information provided by the Tumbleweed Center.
Introduction and Background
8
OFFICE OF THE AUDITOR GENERAL
Figure 1
Homeless Youth Intervention Program
Program Referral, Assessment, and Service Plan Phases
February 1, 2000 through April 30, 2001
Referral Phase—151 youth
Assessment Phase—105 youth
Service Plan Phase—94 youth
Source: Auditor General staff analysis of program’s service specifications and Department of
Economic Security program data for 151 youth whose cases were closed before May
2001.
Do youth and parents consent
to youth’s participation?
46 cases
closed
After a youth is referred and screened for eligibility, a program case manager tries to
locate the youth within 48 hours. When the youth is located, the case manager
describes program services and consent requirements.
Case manager meets with youth alone or with youth and family and conducts
assessment of youth’s current living situation, family relationships, abuse history,
and other personal history relevant to youth’s homelessness.
Does youth agree to develop
and sign service plan?
11 cases
closed
Case manager and youth review youth and family needs, establish goals, identify tasks
necessary to achieve each goal, assign target dates and persons responsible for completing
each task, and meet regularly to update service plan and goal completion information.
Has the youth reunified or
remained with the family or
become self-sufficient?
57 cases closed; youth
reunified or remained
with family or became
self-sufficient
37 cases closed;
youth dropped
out or was no
longer eligible
No
No
No
Introduction and Background
9
OFFICE OF THE AUDITOR GENERAL
n Sixty-six percent reported current or past alcohol and/or
other drug use.
n Sixty percent reported problems with alcohol and/or other
drug use within the family.
n Sixty-three percent reported that they have been victims of
some type of abuse (emotional, physical, and/or sexual
abuse) from one or more family members.
n Sixty percent reported that a family relationship was the
main stressor in their lives.
Figure 2 shows the types of abuse histories reported by the par-ticipating
youth.
Figure 2
Homeless Youth Intervention Program
Reported Rates of Prior Abuse
February 1, 2000 through April 30, 2001
46%
35%
16%
63%
Physical
Emotional or
verbal
Sexual
By family members
Types of Abuse
Source: Auditor General staff analysis of program case file information for 94 youths whose
service plans were closed before May 2001.
Introduction and Background
10
OFFICE OF THE AUDITOR GENERAL
Scope and Methodology
This evaluation, as directed by legislation, examines the pro-gram’s
impact and effectiveness, extent to which the program’s
goals and objectives were achieved, the number of youths who
received services, demographic and provider information, and
the average cost of services provided. It also includes an analysis
of information collected on 94 youths between February 1, 2000
and April 30, 2001, and presents the following two findings:
n The program should work to increase youths’ focus on reuni-fication
or self-sufficiency.
n DES should monitor program costs.
Various methods were used to assess the program, specifically:
n Interviews—The evaluation team interviewed two program
directors, four program managers, five case managers, and
four DES contract administrators to develop an understand-ing
of program implementation and oversight.
n Case File Analysis—For the 94 closed cases, evaluation staff
reviewed case management progress notes and follow-up
documentation to determine reunification and self-sufficiency
outcomes at and beyond case closure. Evaluation
staff also coded and summarized case file information col-lected
in the Youth Assessment and Youth Service Plan
forms to determine program participant characteristics, the
types of goals youths identified, and their progress in achiev-ing
their goals.
n Data Validation—Thirty-eight percent of the program’s case
files were reviewed in order to verify the completeness and
accuracy of the service costs and youth background informa-tion
in the DES database.
n Cost Data Analysis—Cost data was analyzed to determine
total and average cost of all closed cases by phase and types
of services received. Phase of service analysis included 152 re-ferrals,
105 assessments, and 94 closed service plans.
Introduction and Background
11
OFFICE OF THE AUDITOR GENERAL
n Review of DES 2000 Annual Report on Homeless Youth
in Arizona—Evaluators reviewed the report methodology
and structure, the status of homeless youths in Arizona, and
barriers identified by agency directors that limit their ability
to serve runaway and homeless youths.
Acknowledgements
The Auditor General and staff express appreciation to the direc-tor
of the Department of Economic Security; the staff of DES’ Di-vision
of Children, Youth and Families; and the Homeless Youth
Intervention program managers and staff for their cooperation
and assistance throughout the evaluation.
12
OFFICE OF THE AUDITOR GENERAL
(This Page Intentionally Left Blank)
13
OFFICE OF THE AUDITOR GENERAL
FINDING I PROGRAM SHOULD WORK
TO INCREASE YOUTHS’
FOCUS ON REUNIFICATION
OR SELF-SUFFICIENCY
Although it appears the program has had some initial impact,
more can be done to improve the stability of youth outcomes.
Evaluators determined that one-half of the program youths were
reunified with their families or on the path to self-sufficiency
when they left the program. However, many of these youths are
in unstable living situations and most could easily again become
homeless. Further, while they were involved in the program,
youth were more likely to complete goals aimed at meeting basic
needs, such as food or shelter, rather than goals aimed at reunifi-cation
or self-sufficiency. In order to help more youths become
truly reunified or self-sufficient, the program should revise ser-vice
plan procedures to address youths’ critical behavioral needs
and increase family involvement throughout the youth’s partici-pation
in the program.
Half of Youths Reunified
or on Path to Self-Sufficiency
Evaluators determined that at the time of case closure, 47 of the
94 youths were reunified with their families or were on the path
to self-sufficiency, and another 10 youths were still living with
their families.1 Since the program lacks specific outcome defini-tions,
evaluators reviewed program files and developed the fol-lowing
classifications of the youth’s status at closure:
¾ Reunification—Youth is returned to live with a family mem-ber
or guardian.
1 Of the 94 youths who had service plans that were closed before May 2001,
23 dropped out of the program and could not be contacted and 14 were no
longer eligible to participate because they became involved with Child
Protective Services or the courts.
Finding I
14
OFFICE OF THE AUDITOR GENERAL
¾ Self-sufficiency—Youth now lives on his/her own with or
without some program assistance.
¾ Family Preservation—Youth had been living with his/her
family during program participation despite being at risk of
running away or being thrown out of the home, and contin-ues
to live at home with family members.
As shown in Figure 3, evaluators found that at case closure, 25
youths were reunified with family members, 22 were on the path
to becoming self-sufficient, and 10 continued to live with their
families.
Nearly Half of Youth
in Unstable or Unknown
Living Situations at Closure
Even though half of the program youths were reunified with
their families or on the path to self-sufficiency at case closure, for
Figure 3
Homeless Youth Intervention Program
Youth Status at Case Closure
February 1, 2000 through April 30, 2001
Status
unknown (23)
Self-sufficient
(22)
Reunified (25)
Remained with
family (10)
No longer
eligible (14)
Source: Auditor General staff analysis of program case file information for 94 youth
where service plans were closed before May 2001.
Finding I
15
OFFICE OF THE AUDITOR GENERAL
many, this may be only a temporary condition. Over half of the
reunified youth and half of the self-sufficient youth were in un-stable
or unknown living situations. In order to track the stability
and quality of the youths’ outcomes, the program should
conduct follow-up interviews with its clients at several points in
time after they leave the program.
The family relationships and living situations for the homeless
youth population are typically volatile and often involve serious,
long-term problems such as physical, verbal, or sexual abuse and
substance abuse. Further, some of the youths have repeatedly
changed residences or have run away and returned home only
to run away again. Therefore, a further assessment was needed
of the quality and stability of the youths’ relationships and living
situation both when they leave the program and later. Accord-ingly,
evaluators further classified the youth’s reunification or
self-sufficiency status at closure as stable, unstable, or unknown.
More than half of reunification cases unstable or of unknown
stability—As Table 3 illustrates, evaluators determined that 13
of the 25 youth reunified at case closure were in unstable situa-tions
or situations in which the degree of stability was unknown.
Specifically, three reunification cases were considered unstable
because the case manager notes indicated that even though the
Table 3
Homeless Youth Intervention Program
Youth Stability at Case Closure
February 1, 2000 through April 30, 2001
Status Stability
Status Stable Unstable Unknown Total
Reunified 12 3 10 25
Self-sufficient 11 3 8 22
Remained with family 7 1 2 10
Total 30 7 20 57
Source: Auditor General staff analysis of program case management
progress notes for 57 youth who were eligible and in contact with the
program at case closure and whose service plans were closed before
May 2001.
Finding I
16
OFFICE OF THE AUDITOR GENERAL
youth was with family, he or she was “not doing well” or “still
running away.” Consider the following example of a youth re-unified
with her family but in an unstable situation:
Further, the stability of the living situations and family relation-ships
of the remaining ten reunified youth are still unclear. The
case manager notes and closure documentation on many of these
youths indicated only that the youth was returned to live with
the family and was out of contact with the program. In the ex-ample
below, it is not clear whether the youth and family had
improved their relationship or whether the youth was likely to
run away again.
Susan’s grandmother contacted the program because
Susan had been running away and using drugs. Susan
was placed in temporary shelter but then left the pro-gram
and returned to her grandmother’s home. Susan
and her grandmother never showed up for scheduled
counseling appointments. After many attempts, the
case manager finally contacted the grandmother 3
weeks later and learned that Susan was “doing terri-ble,”
and was running away all the time. After repeated
attempts to contact Susan again, the case was closed.
Susan
In the past, John had been homeless, kidnapped, and
sexually molested. Due to the stress and conflict of
living with his stepmother and father, John took res-pite
in the program’s temporary shelter. One week
later, John left the shelter and returned home, but he
and his parents did not show up for any scheduled
family counseling sessions. Further, the family did
not return any of th e case manager’s phone calls, so
the case was closed.
John
Finding I
17
OFFICE OF THE AUDITOR GENERAL
By contrast, 12 reunification cases were considered stable be-cause
case manager notes indicated that the youth was returned
to live with the family and was “doing fine,” “happy,” or “in
regular family counseling to address family issues.”
Half of the self-sufficient cases were unstable or of unknown
stability—Similar to the reunified youth, half of the youth who
evaluators classified as self-sufficient at case closure were in un-stable
situations or in situations where the degree of stability was
unknown. Specifically, three youths were considered self-sufficient
but unstable. For example, one youth was living on her
own when she left the program, but her utilities had been cut off
and she was months behind in paying her rent. Further, the sta-bility
of eight other self-sufficient youths was unclear at the time
of case closure. For example:
Finally, even most of the youths classified as self-sufficient and
stable were in conditions that could change because their living
situation was only temporary. Nine of the 11 youth were still in
independent or transitional living programs at the time of case
closure and only 2 were living on their own.
Program should track youth outcomes after case closure—At the
time of this evaluation, 74 of the 94 closed cases were due for
scheduled 30-day followups. Of these cases, case managers had
successfully contacted 18 youth. The program needs to system-
Rex left his mom’s home on bad terms and lived on his
own in 13 different places in just 1 year. The program as-sisted
him with clothing, eyeglasses, transportation, and
case management services. Rex had been working and
was expected to move into a new apartment, but at the
last minute, he said he was moving to Indiana to be with
his biological father. After unsuccessful a ttempts to reach
him in Indiana, the case manager closed his case.
Rex
Finding I
18
OFFICE OF THE AUDITOR GENERAL
atically track youth after they leave it to measure its impact on
their lives in critical areas, such as the youth’s living situation,
family relations, and ability to live independently. Further, as
stated in the contract with DES, the program is expected to con-duct
follow-up or assessment of participants’ achievement in or-der
to conform with the “best practice” for service delivery. Fol-low-
up information has not been collected consistently and it has
not been analyzed and included in the program’s monthly re-ports
to DES.
To effectively use follow-up information to measure outcomes,
the program should implement the following processes:
Actions Needed for
Effective Followup
1. Modify intake forms to better ensure youth
can be contacted once they leave the program.
Such modifications should include the names,
addresses, and phone numbers of people who
would know where the youth is living.
2. Contact youth at 30-, 60-, and 90-day intervals.
3. Complete all steps of the follow-up process at
all sites and sufficiently train all staff to admin-ister
the same interview schedule.
4. Analyze completed follow-up interviews and
include summarized information in the
monthly reports to DES.
5. Provide additional information to the youth if
during the follow-up program staff identify
additional concerns or youths are in need of
more services.
Finding I
19
OFFICE OF THE AUDITOR GENERAL
Youths Primarily Complete
Goals That Meet Basic Needs
Although many youths who leave the program return to unsta-ble
living conditions, the majority do complete some goals while
involved in the program. However, most of these goals are those
that are more easily met, such as food or shelter. Youths com-plete
fewer goals specifically related to reunifying with family or
becoming self-sufficient. Youths’ success in meeting the reunifi-cation
or self-sufficiency goals may be limited because the service
plans often fail to address critical behavioral issues, such as sub-stance
use, and most service plans do not involve family mem-bers,
despite a clear need to do so.
As part of the Youth Development Approach used by the pro-gram,
youths and case managers develop service plans together.
Once goals are identified, the case manager and the youth sepa-rate
each goal into smaller tasks and assign target completion
dates and the person responsible for completing each task. In a
typical service plan for the 94 closed cases, 2 to 3 goals were iden-tified,
each with 5 to 6 tasks.
Basic needs goals completed at higher rates than self-sufficiency
or reunification goals—Although more than half of the 94 youth
had at least 75 percent of their service plan goals completed,
youth were more likely to complete goals related to meeting ba-sic
needs rather than those related to reunification or self-sufficiency.
As Figure 4 (see page 20) illustrates, 73 percent of the
Examples of Different Goals
Basic needs goals:
Ø “Find youth a temporary place to live”
Ø “Provide youth with cash assistance for food”
Reunification goals:
Ø “Begin weekly family counseling sessions with
youth and family”
Ø “Buy bus ticket to return youth to family”
Self-sufficiency goals:
Ø “Get youth a job”
Ø “Assist youth in maintaining a budget”
Finding I
20
OFFICE OF THE AUDITOR GENERAL
basic needs goals were completed, compared to 49 percent of the
reunification goals and 54 percent of the self-sufficiency goals.1
The higher completion rate of the basic needs goals reflects the
program’s strength in serving the immediate needs of its trou-bled
client population. In contrast, the lower completion rates for
reunification and self-sufficiency goals reflect the program’s
struggle with moving youths to goals beyond their immediate
needs.
Service plans seldom address critical behavioral needs—
Although program participants suffer from self-damaging be-havior
and family problems that can impact their ability to
achieve self-sufficiency or reunification goals, service plans sel-dom
address these problems. Specifically, during the assessment
phase, two-thirds of the 94 youth reported current or past alco-hol
and/or other drug use and 35 percent reported mental health
problems. However, only 6 of the 223 service plan goals related
to substance use treatment or mental health issues. The following
1 Youths and case managers identified 85 basic needs goals, 43 reunification
goals, and 95 self-sufficiency goals.
Figure 4
Homeless Youth Intervention Program
Service Plan Goal Completion Rates
February 1, 2000 through April 30, 2001
49%
54%
73%
46%
51%
27%
0% 20% 40% 60% 80% 100%
Self-sufficiency
(95 goals)
Reunification (43
goals)
Basic needs (85
goals)
Type of Goal
Percentage completed Percentage not completed
Source: Auditor General staff analysis of program case file information for 94 youth
where service plans were closed before May 2001.
Finding I
21
OFFICE OF THE AUDITOR GENERAL
case illustrates the gap between needs identified at assessment
and goals developed in the service plan phase:
Failure to address critical needs may be due to limitations in the
program model—The Youth Development Approach used by
the program is based on the premise that a youth cannot be
forced to receive a service or to address a specific problem, such
as abuse history. Rather, the youth decides what, if anything, he
or she wants or needs to address. However, critical behavioral
problems, such as drug abuse or physical abuse, can contribute
to the problems in the youth’s current living situation and family
relationships and can impede progress toward family reunifica-tion
or self-sufficiency. The program should assist youth in de-veloping
service plan goals that address these critical behavioral
needs and help youths see the connection between addressing
such needs and achieving reunification or self-sufficiency goals.
Family involvement minimal—Although most youths identified
family relationships as their main stressor in life, family mem-bers
were rarely involved in the development and completion of
service plan goals. A lack of family involvement is a barrier to
meeting the needs of homeless youth seeking reunification, ac-cording
to DES’ 2000 annual report on Arizona’s homeless
youth. While the 94 youth typically set 4 to 5 tasks for each goal,
only 25 percent of the tasks associated with reunification goals
involved their family members. Further, a review of 36 youth
Linda reports a previous diagnosis of manic depres-sion
(bipolar disorder), but she is not taking medica-tion
for her mental illness. She admits to drinking al-cohol
and smoking marijuana and crystal metham-phetamine.
Linda has only one service plan goal, but
it incorporates a number of need areas. The goal
reads “Survival—Basic Needs, Continue Education,
and Lower Stress.” The five tasks accompanying her
goal read as follows: “Clothes,” “Food,” “Research
place to live,” “Pay for G.E.D,” and “Spirituality
books.”
Linda
Youth may not identify
goals that address criti-cal
behavioral needs.
Finding I
22
OFFICE OF THE AUDITOR GENERAL
case files found that only 19 percent included a family assess-ment,
although the program requires this assessment to be com-pleted
for all youths. Family assessments help the case manager,
youth, and family to identify family issues that should be ad-dressed
in the youth’s service plan. Conducting family assess-ments
in addition to youth assessments and involving family
members in service plan tasks could improve the program’s abil-ity
to address problems that stem from family relationships.
Therefore, the program should complete family assessments for
all youths and increase efforts to involve the family, by telephone
or in person, in the assessment and service plan phases.
Finding I
23
OFFICE OF THE AUDITOR GENERAL
Recommendations
1. The program should improve follow-up efforts in order to
better determine its impact on the lives of the youths it
serves. Specifically, it should:
a. Modify intake forms to better ensure youth can be con-tacted
once they leave the program. Such modifications
should include the names, addresses, and phone num-bers
of people who would know where the youth is liv-ing.
b. Contact youth at 30-, 60-, and 90-day intervals as re-quired.
c. Complete all steps of the follow-up process at all sites and
sufficiently train all staff to administer the same interview
schedule.
d. Analyze completed follow-up interviews and include
summarized information in the monthly reports to DES.
e. Provide additional information to the youth if during the
follow-up program staff identify additional concerns or
youths are in need of more services.
2. The program should assist youths in developing service plan
goals that address critical behavioral needs identified at as-sessment.
3. The program should complete family assessments for all
youths in the program as required and increase the level of
family involvement at the assessment and service plan
phases.
24
OFFICE OF THE AUDITOR GENERAL
(This Page Intentionally Left Blank)
25
OFFICE OF THE AUDITOR GENERAL
FINDING II DES SHOULD MONITOR
PROGRAM COSTS
DES needs to monitor program costs related to the capitated
rates and housing costs. The capitated rates for two of the three
program phases are higher than actual costs. Therefore, DES
should monitor program costs so that it can ensure that the rates
in future contracts more closely reflect actual service costs. Fur-ther,
more than 80 percent of the program’s expenditures were
for housing, and most of this money went to house relatively few
youths. While other homeless youth programs limit the length of
time they will support youth in shelter care, this program has the
flexibility to provide shelter for longer periods. However, to en-sure
that the program can help as many youths as possible, DES
needs to consider policies that control housing costs.
Some Capitated Rates
Exceed Actual Costs
DES should ensure that the capitated rates for the program
phases more closely reflect actual service costs. Evaluators re-viewed
program costs and found capitated rates exceeded pro-gram
costs for two of the three program phases.1 Therefore, DES
should monitor program costs so that it can ensure that capitated
rates more closely match actual service costs in future contracts.
Capitated rates exceed costs for two phases—As shown in Table
4 (see page 26), while the capitated rate approximates the actual
average cost for services provided during the referral phase, the
capitated rate for the assessment phase is 267 percent higher
($160) than the average cost. Further, the capitated rate for the
service plan phase is 15 percent higher ($423) than the average
cost.
1 The capitated rates referred to in this finding are for the delivery of pro-gram
services and are as follows: $44 for referral phase, $220 for assess-ment
phase, and $3,168 for service plan phase. These rates do not include
the 12 percent administrative fee that Tumbleweed withholds for adminis-trative
expenses.
Capitated rates exceed
average assessment and
service plan costs.
Finding II
26
OFFICE OF THE AUDITOR GENERAL
DES should monitor program costs for use in future contract de-cisions—
DES should ensure that the capitated rates more closely
approximate program costs in future contracts. The existing capi-tated
rates were established based on estimates developed by the
program contractor, Tumbleweed. Since the program was new,
Tumbleweed estimated its costs for each service phase based on
various factors, such as shelter care, the dropout rates of youth in
other programs, and DES’ service specifications for the program.
In addition, Tumbleweed compared the services it should
provide with the services provided by DES’ Family Builders
program, and considered the capitated rates DES paid for this
program in arriving at its estimates.
DES extended its original contract with Tumbleweed through
June 30, 2002. DES anticipates that it will renew the contract for 1
additional year. Given that the program is relatively new and
only 15 months of cost data was available at the time of this
evaluation, DES should monitor program costs so that it can en-sure
capitated rates more closely match actual service costs in
future contracts.
Table 4
Homeless Youth Intervention Program
Comparison of Capitated Rates to Average Actual Costs
February 1, 2000 through April 30, 2001
Program
Phase1
Capitated
Rate2
Average
Actual Cost Difference
Referral $ 44 $ 46 ($ 2)
Assessment 220 60 160
Service Plan 3,168 2,745 423
1 Of the 151 youth referred to the program, 105 participated in the assessment
phase and 94 participated in the service plan phase.
2 Does not include 12 percent administrative fee.
Source: Auditor General staff analysis of Department of Economic Security
program cost data for 151 youths whose cases were closed before May
2001.
Finding II
27
OFFICE OF THE AUDITOR GENERAL
Program Should Monitor
Housing Costs
The program spends a large amount of money on housing costs
for only a few youths, but does not monitor them to ensure that
the housing costs for each youth are justified by his or her needs
throughout program participation. The program provides youth
two primary types of housing: short-term shelter care and
longer-term transitional living placement. Evaluators found that
82 percent of the service plan phase costs were for housing and a
majority of the service plan costs were incurred by 12 youth.
Since high housing costs could hinder the program from serving
additional clients in the future, it should monitor shelter care and
transitional living costs and DES should develop policies, as
needed, to manage these costs.
Youths are provided shelter care and/or transitional living
placement—The program provides two primary types of hous-ing
to youth: shelter care and transitional living placement. Shel-ter
care is typically a short-term respite to allow youths an option
other than living with their families or living on the streets.
When youths are placed in shelter care, their basic needs of hous-ing,
food, clothing, and transportation are met. However, youths
do receive some independent living and life skills training, coun-seling,
and character education.
Transitional living is typically a longer-term placement designed
for youths who are trying to attain self-sufficiency rather than
returning to live with their families. Youths who are placed in
transitional living reside in their own apartments where they live
on their own, although not completely independent of program
staff. Similar to youth in shelter care, the youth receive skills
training, counseling, and character education. When the youth
becomes employed, a portion of his or her pay is put into a sav-ings
account to help the youth live independently.
Most service plan phase costs paid for housing 12 youths—As
shown in Figure 5 (see page 28), nearly $212,000 of the $258,053
of service plan phase costs, or 82 percent, were for housing. The
remaining 18 percent of service plan phase costs were attributed
to case management and other services.
Eighty-two percent of
service plan costs were for
housing.
Finding II
28
OFFICE OF THE AUDITOR GENERAL
Further, as Table 5 (see page 29) illustrates, 12 youths incurred a
total of $144,155, or 56 percent, of total service plan phase costs.
Most of these 12 youths’ costs were for housing. Their average
length of stay in shelter care and/or transitional living was 108
days, at an average cost of $11,102. In comparison, the average
length of stay for the other 82 youth was 9 days, at an average
cost of $956.
Program should monitor and manage housing costs—Since the
program’s inception, it has not had any youth on a waiting list to
receive services. However, staff have managed their outreach
efforts so that they can adequately serve all youth who enter the
program. Since high housing costs could hinder the program
from serving additional clients in the future, it should monitor
shelter care and transitional living costs and develop policies, as
needed, to manage these costs.
Figure 5
Homeless Youth Intervention Program
Service Plan Phase Costs by Type of Service
February 1, 2000 through April 30, 2001
Case
Management
($35,343)
Other
($11,084)
Housing
($211,626)
Source: Auditor General staff analysis of Department of Economic Security
program data for 94 youths whose service plans were closed before
May 2001.
Finding II
29
OFFICE OF THE AUDITOR GENERAL
Limitless housing stays
may address the needs of
some youths while hinder-ing
service to others.
The program has not established a maximum number of days
that a youth can spend in shelter care or transitional living
placement, but federal guidelines for other programs limit shel-ter
stays to 15 days and transitional living to 18 months. Because
of problems with the program’s categorization of housing data,
evaluators were unable to determine the total number of days
youth received housing services, and how many of these days
were in shelter care and how many were in transitional living
placement. Further, evaluators were unable to determine how
much of the nearly $212,000 spent for housing was for shelter
care versus transitional living. For example, in some cases, the
program coded transitional living costs as shelter care costs and
vice versa. However, evaluators were able to obtain accurate
data for 3 of 11 youth with high housing costs and found that
they spent extended amounts of time in shelter care, ranging
from 33 days to 128 days.
Given that shelter care is typically a short-term respite, the pro-gram
needs to develop processes to monitor youths’ housing
situations. First, the program should ensure that it categorizes
housing costs appropriately. Second, the program should sys-tematically
review the cases of youths in shelter care or transi-tional
living to determine the cost and the ongoing purpose and
justification for housing each youth. Such a review could help
ensure that the cost of the youth’s housing is justified by his or
Table 5
Homeless Youth Intervention Program
Average Actual Cost of Service Plan Services
February 1, 2000 through April 30, 2001
Average Cost per Case Total Cost
Number of Cases Housing
Case
Management
Other
Services Total
12 most expensive $11,102 $712 $199 $12,013 $144,155
82 less expensive 956 327 106 1,389 113,898
94 total 2,251 376 118 2,745 258,053
Source: Auditor General staff analysis of Department of Economic Security program cost data for
94 youth whose service plans were closed before May 2001.
Finding II
30
OFFICE OF THE AUDITOR GENERAL
her needs throughout program participation. Finally, DES
should develop policies, as needed, to limit the number of days a
youth can stay in shelter and transitional living based on his or
her progress while in the program.
Recommendations
1. DES should monitor program costs and ensure the capitated
rates better reflect actual service costs in future contracts.
2. The program should ensure that it categorizes housing costs
appropriately.
3. The program should monitor housing costs and youths’ pro-gress
while in shelter care or transitional living.
4. DES should develop policies, as needed, to limit the number
of days a youth can stay in shelter care and transitional living
program based on the youth’s progress while in the program.
OFFICE OF THE AUDITOR GENERAL
AGENCY RESPONSE
OFFICE OF THE AUDITOR GENERAL
(This Page Intentionally Left Blank)
__________________ ARIZONA DEPARTMENT OF ECONOMIC SECURITY __________________
1717 W. Jefferson, P.O. Box 6123, Phoenix, Arizona 85005
Jane Dee Hull John L. Clayton
Governor Director
Ms. Debbie Davenport, CPA
Office of the Auditor General
2910 North 44th Street, Suite 410
Phoenix, AZ 85005
Dear Ms. Davenport:
The Department wishes to thank the Office of the Auditor General for the opportunity to
respond to the recently completed draft evaluation of the Homeless Youth Intervention
Program.
I am pleased your findings indicate the program has had an impact on the youth we serve. The
findings indicate that in the first fifteen months of its existence the program was able to serve
ninety-four youth. It was also determined that one-half of the youth served were reunified with
their families or on the path to self-sufficiency when they left the program.
Included in the draft report is the recommendation that the Department needs to consider
policies that control housing costs, such as limiting shelter care and transitional living stays based
on the reviews of youths’ progress while they are in the program. The Department welcomes
the opportunity to work with the providers in making these changes.
We agree with both findings contained in this draft report. The recommendations pertaining to
each finding will be implemented as indicated in our accompanying response.
Finally, please accept our appreciation for the time and effort invested in this important
evaluation. We wish to specifically recognize Jeff Kleist and Tara Lennon for their hard work
during the evaluation process.
Sincerely,
John L. Clayton
Enclosure
1
Department of Economic Security Response
To The
Homeless Youth Intervention Program Evaluation
The Department wishes to thank the Office of the Auditor General for the opportunity to review and
respond to the revised preliminary draft Homeless Youth Intervention Program (HYIP) evaluation. The
time and effort spent evaluating the program is appreciated.
FINDING I: Program Should Work To Increase Youths’ Focus On
Reunification Or Self-Sufficiency
The finding of the Auditor General is agreed to and the following
recommendations will be implemented.
1) The program should improve follow-up efforts in order to better determine its impact on the lives of
the youths it serves is agreed to. Specifically, it should:
a) Modify intake forms to better ensure youth can be contacted once they leave the program.
Such modifications should include the names, addresses, and phone numbers of people who
would know where the youth is living.
The finding of the of the Auditor General is agreed to and the audit recommendation
will be implemented. The Department will modify intake forms to include the
names, addresses, and phone numbers of people who would know where the youth
is living.
b) Contact youth at 30, 60, and 90 day intervals as required.
The finding of the Auditor General is agreed to and the audit recommendation will be
implemented. The Department will implement procedures to contact youth at 30,
60, and 90 day intervals.
c) Complete all steps of the follow-up process at all sites and sufficiently train all staff to administer
the same interview schedule.
The finding of the Auditor General is agreed to and the audit recommendation will be
implemented. The Department will complete all steps of the follow-up process at
all sites and sufficiently train all staff to administer the same interview schedule.
2
d) Analyze completed follow-up interviews and include summarized information in the monthly
reports to DES.
The finding of the Auditor General is agreed to and the audit recommendation will be
implemented. The Department will request follow-up interviews and request that
summarized information is included in the monthly reports to DES.
e) Provide additional information to the youth if during the follow-up program staff identify
additional concerns or youths are in need of more services.
The finding of the Auditor General is agreed to and the audit recommendation
will be implemented. The Department will request that during the follow-up,
program staff identify additional concerns or youths that are in need of more
services.
The Department recognizes that the Homeless/Runaway Youth Program is still in the
implementation phase and has program improvements that need to be made. The Department
agrees to design a monitoring tool and process that will improve follow-up efforts and increase
our success in locating youth after they leave the program. The process will be used on a 30,
60, and 90 day interval schedule and all staff will be trained at regular intervals and on an as-needed
basis.
The monitoring will be designed to ensure that program data is captured and reported
appropriately.
2. The program should assist youths in developing service plan goals that address critical behavioral
needs identified at assessment.
The finding of the Auditor General is agreed to and the audit recommendation
will be implemented. The program will assist youths in developing service plan
goals that address critical behavioral needs identified at assessment.
When providers begin services for the youth, it is crucial that the basic needs of the youth are
met. The providers should gain the youth’s trust, and show the youth that they are genuinely
concerned for the youth’s safety and well-being. The first approach with runaway youth is to
reunite them with their families whenever possible.
Once the primary needs are met, the provider can have a more stable base from which to
operate. Over time the provider can explore the longer-term needs as part of a case plan to
enhance the youth’s stability and self-sufficiency, which would include addressing substance
abuse issues or mental health needs.
3
The engagement of clients and the development of rapport is paramount. Since this program is
wholly voluntary and designed to address those youth who are outside of the Juvenile Court and
Child Protective Services systems, providers cannot force a youth to be involved in services in
which the youth are unwilling or unable to participate. The providers have no means to compel
them into treatment, job placement, or housing. It would be ill-advised to withhold services,
pending the youths compliance with unrealistic timelines and goals.
3. The program should complete family assessments for all youths in the program as required and
increase the level of family involvement at the assessment and service plan phases.
The finding of the Auditor General is agreed to with the understanding that the
assessment is not a traditional family assessment, but rather an assessment that
is used to gather background information, including relevant information
pertaining to the youth. The program will complete assessments for all youths in
the program as required and increase the level of family involvement at the
assessment phases. The Program is voluntary and does not require family
involvement for involvement participation.
Finding II: DES Should Monitor Program Costs
The finding of the Auditor General is agreed to and the following audit
recommendations will be implemented.
1. DES should monitor program costs and for future contracts renegotiate the capitated rates to better
reflect actual service costs.
The finding of the Auditor General is agreed to and the audit recommendation
will be implemented. The Department will monitor program costs, and for future
contracts, renegotiate the capitated rates to better reflect actual service costs.
2. The program should ensure that it categorizes housing costs appropriately.
The finding of the Auditor General is agreed to and the audit recommendation
will be implemented. The program will ensure that housing costs are categorized
appropriately.
3. The program should monitor housing costs and youths’ progress while in shelter care or transitional
living.
The finding of the Auditor General is agreed to and the audit recommendation
will be implemented. The program will monitor housing costs and youth’s
progress while in shelter care or transitional living.
4
4. DES should develop policies, as needed, to limit the number of days a youth can stay in shelter
care, and transitional living program based on the youth’s progress while in the program.
The finding of the Auditor General is agreed to and the audit recommendation
will be implemented. The Department will develop policies, as needed, to limit the
number of days a youth can stay in shelter care, and transitional living program
based on the youth’s progress while in the program.
Other Performance Audit Reports Issued Within
the Last 12 Months
01-10
Future Performance Audit Reports
Department of Health Services—Behavioral Health Services Reporting Requirements
01-1 Department of Economic Security—
Child Support Enforcement
01-2 Department of Economic Security—
Healthy Families Program
01-3 Arizona Department of Public
Safety—Drug Abuse Resistance
Education (D.A.R.E.) Program
01-4 Arizona Department of
Corrections—Human Resources
Management
01-5 Arizona Department of Public
Safety—Telecommunications
Bureau
01-6 Board of Osteopathic Examiners in
Medicine and Surgery
01-7 Arizona Department
of Corrections—Support Services
01-8 Arizona Game and Fish Commission
and Department—Wildlife
Management Program
9 Arizona Game and Fish
Commission—Heritage Fund
01-10 Department of Public Safety—
Licensing Bureau
01-11 Arizona Commission on the Arts
01-12 Board of Chiropractic Examiners
01-13 Arizona Department of
Corrections—Private Prisons
01-14 Arizona Automobile Theft
Authority
01-15 Department of Real Estate
01-16 Department of Veterans’ Services
Arizona State Veteran Home,
Veterans’ Conservatorship/
Guardianship Program, and
Veterans’ Services Program
01-17 Arizona Board of Dispensing
Opticians
01-18 Arizona Department of Correct-ions—
Administrative Services
and Information Technology
01-19 Arizona Department of Education—
Early Childhood Block Grant
01-20 Department of Public Safety—
Highway Patrol
01-21 Board of Nursing
01-22 Department of Public Safety—
Criminal Investigations Division
01-23 Department of Building and
Fire Safety
01-24 Arizona Veterans’ Service
Advisory Commission
01-25 Department of Corrections—
Arizona Correctional Industries
01-26 Department of Corrections—
Sunset Factors
01-27 Board of Regents
01-28 Department of Public Safety—
Criminal Information Services
Bureau, Access Integrity Unit, and
Fingerprint Identification Bureau
01-29 Department of Public Safety—
Sunset Factors
01-30 Family Builders Program
01-31 Perinatal Substance Abuse
Pilot Program