Income Eligible ContractProvider Outreach

Fiscal CommitteeMarch 3, 2014

Background on Issue In calculating our projections every month, we assume

100% contract utilization. This helps guard against deficiencies.

EEC projections assume flex slots are funded through underutilization. Therefore, when evaluating the contract providers, our preference is to have contract utilization percentages fall between 90% and 95%.

During the current fiscal year, however, contract utilization percentages have not been in the 90s until this month. The low was 83.08% at the end of August with recent months holding steady around 88%.

This contract underutilization is contributing to the projected surplus in the Income Eligible account.

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FY13/14 IE Contract Slots - Regular and Flex

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Data Report created on February 27, 2014

Total Awarded Slots is 14,521 and Allowable Flex Slots is 836. 324 of the 355 additional contract slots awarded have been filled. 20 Vendors representing 23 contracts are Over 5% Flex **No. of children filling slots may be greater than slots awarded.Total awarded slots for Homeless is 693 and Teen 506. - Homeless: filled 569 open 124 - Teen: filled 401, open 105

Report Date Regular Filled Regular Open Flex Filled% Filled

(with Flex)Flex Open

Flex - Over 5%

Flex - Under 5%

2/27/2014 13,006.0 1,515.0 141.0 90.54% 695.0 (53.0) 748.0 1/28/2014 12,766.5 1,754.5 138.5 88.87% 697.5 (56.0) 753.5

12/31/2013 12,673.5 1,862.5 149.0 88.21% 687.0 (63.5) 750.5 11/26/2013 12,875.0 1,897.0 174.0 88.34% 674.0 (61.5) 826.5 10/30/2013 12,764.0 2,008.0 168.5 87.55% 679.5 (72.0) 751.5

9/26/2013 12,438.0 2,361.0 171.0 85.20% 680.5 (71.5) 752.0 8/31/2013 12,190.0 2,610.0 106.0 83.08% 745.0 (41.5) 786.5 7/31/2013 13,052.0 1,748.0 145.0 89.17% 706.5 (71.5) 778.0 5/27/2013 13,395.0 1,404.0 201.5 91.87% 649.5 (96.5) 746.0 4/29/2013 13,567.0 1,267.0 209.5 92.87% 647.5 (100.0) 747.5 3/28/2013 13,587.0 1,256.0 210.0 92.95% 647.0 (99.5) 746.5 2/28/2013 13,195.5 1,292.5 213.5 92.55% 643.5 (98.5) 742.0

As of February 27, 2014 the number of open slots has decreased by 239.5 slots (1754.5 vs. 1515.0). The percentage of slots open is 10.43%. Including the flex slots used, the contract providers have a 9.46% vacancy rate. In comparison to last year the vacancies have increased by 2.01%. On average, for the past 12 months the contract providers contract slots have been 89.27% filled, with a peak occupancy of 92.95% at the end of March 2013 and the lowest occupancy at 83.08% at the end of August 2013.

Contract Utilization Review We started by evaluating utilization data from 12/31/13 to find

any patterns in the underutilization (by region, program type, vendor, etc). There was no obvious pattern to a particular region or type of program.

With no obvious patterns, we turned to looking at the 170 contract providers. Specifically, we discovered the following (all percentages do not include flex spot utilization): 26 providers were at 100% utilization. 92 providers were at 90% or above. 42 providers were below 80%. The 21 vendors with the most open slots represented 56.6%

of all open slots, but some of these vendors were over 90%. The 20 vendors with the lowest slots filled percentage

ranged from 0% to 58.33% and represented 637.5 open slots (34.2% of total available). This is the group we decided to focused our outreach on.

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Contract Provider Outreach In an effort to maximize contract utilization, we started

reaching out to certain contract providers, focusing on the 20 contract providers who have the lowest percentage of awarded slots (as mentioned before).

These providers ranged from 0% of slots filled to 58% of slots filled.

We contacted each of the contract providers individually and asked the following questions: What are the main challenges you face in filling your

contracted slots? What steps have you taken to fill the open slots? Have you contacted your local CCR&R to say that

you have slots available? If these slots are not able to be filled, should we take

down these slots?

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Details on Providers Contacted

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VendorRegular

Slots Awarded

Regular Slots Used

Regular Slots

Available

% Regular Slots Filled

Flex Spots Awarded

Flex Slots Used

Total Slots Awarded

Total Slots Filled

% Total Slots Filled

1 17.0 0.0 17.0 0.00% 1.0 0.0 18.0 0.0 0.00%2 12.0 0.0 12.0 0.00% 1.0 0.0 13.0 0.0 0.00%3 10.0 0.0 10.0 0.00% 2.0 0.0 12.0 0.0 0.00%4 22.0 3.0 19.0 13.64% 2.0 0.0 24.0 3.0 12.50%5 16.0 4.0 12.0 25.00% 1.0 0.0 17.0 4.0 23.53%6 8.0 2.0 6.0 25.00% 3.0 0.0 11.0 2.0 18.18%7 48.0 18.0 30.0 37.50% 4.0 0.0 52.0 18.0 34.62%8 26.0 10.0 16.0 38.46% 4.0 0.0 30.0 10.0 33.33%9 13.0 5.0 8.0 38.46% 2.0 0.0 15.0 5.0 33.33%10 117.0 49.0 68.0 41.88% 6.0 0.0 123.0 49.0 39.84%11 83.0 39.0 44.0 46.99% 4.0 0.0 87.0 39.0 44.83%12 20.0 9.5 10.5 47.50% 1.0 0.0 21.0 9.5 45.24%13 80.0 41.0 39.0 51.25% 4.0 0.0 84.0 41.0 48.81%14 58.0 30.0 28.0 51.72% 3.0 0.0 61.0 30.0 49.18%15 520.0 271.0 249.0 52.12% 27.0 0.0 547.0 271.0 49.54%16 46.0 25.0 21.0 54.35% 2.0 0.0 48.0 25.0 52.08%17 29.0 16.0 13.0 55.17% 2.0 0.0 31.0 16.0 51.61%18 55.0 31.0 24.0 56.36% 3.0 0.0 58.0 31.0 53.45%19 14.0 8.0 6.0 57.14% 1.0 0.0 15.0 8.0 53.33%20 12.0 7.0 5.0 58.33% 2.0 0.0 14.0 7.0 50.00%

Grand Total 1,206.0 568.5 637.5 47.14% 75.0 0.0 1,281.0 568.5 44.38%

Major Themes in Provider Feedback The waitlist continues to be a major issue and was raised by every

provider contacted. Most common waitlist issues are: Invalid Contact information which adds to the amount of time

providers spend sending out letters. Parents still on the waitlist even though they are enrolled in

another program. Waitlist families receiving multiple letters. Families no longer being eligible.

All providers also identified issues with the families, including difficulties in getting parents to complete the certification process.

Many providers said that they often have families walk away after they find out that there is a parent fee.

Multiple providers said that families have rejected contract slots saying that they don’t want to miss out on a voucher slot.

A number of providers cited affordability. Some said that they can’t afford to keep a slot open when they have a waitlist of private payers. Others said that when a family with a voucher comes, they don’t want to turn down the income. At the same time, they can only afford to have a certain number of subsidized spots so the voucher family goes into what would otherwise be an open contracted slot.

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Major Themes in Provider Feedback Boston area providers cited the increase in K1 classrooms in

Boston Public Schools as a issue with filling their pre-school classrooms. Many parents are choosing BPS over EEC programs because there are no parent fees and because it can help get a child established in the parents’ school of choice.

A few providers in New Bedford and Boston cited continuing economic issues in their region since these areas continue to have higher unemployment rates. Many of their parents have been getting laid off or had hours reduced so they no longer qualify for full time care. New families are having difficulty finding full time work, especially within the 8 weeks provided under a job search placement.

Providers who work with a high number of immigrant populations cited unique issues including undocumented parents who could not prove their income. These providers also cited translation issues – providers have translators to help but EEC forms are only in English. Some parents insist on having someone else translate the form which leads to delays and issues completing certification within 45 days. Other parents sign anything to get their children into care and have issues during recertification because they did not know what they were supposed to do in order to be in compliance.

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Provider Specific Concerns Two providers cited conflicts between the Head Start guidelines and

EEC requirements as a key issue with filling slots. Principle issues are: The lower income threshold for Head Start. The EEC work/school requirements that many lower income

families cannot meet. EEC documentation requirements – particularly income

documentation which is difficult for undocumented workers. When a family is removed from an EEC slot, they are often not

removed from Head Start which leads to capacity issues. Two providers moved to a new location over the summer but had

delays in the licensing process so they could not begin filling slots again until mid-late fall.

One provider had enrollment frozen and lost a number of families due to compliance issues. They have are now working with EEC staff on the compliance issues and on refilling the open slots.

One provider mentioned issues with EEC’s attendance requirements. They are a Head Start provider that serves lower income children who tend to have more health issues. It is especially difficult in relation to the requirements around how long a child must be absent when they have certain illnesses, because if a child gets multiple illness and are required to stay out a certain amount of time with each illness, it can add up to 30 days very quickly.

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Short-term Solutions Take down the slots identified by nine providers as not able to

be filled (77 total slots). Consider having some EEC forms translated into other

languages to fix difficulties that have arisen with immigrant families.

Consider providing guidance or additional training to help providers with EEC policies and procedures, such as waitlist procedures.

Issue a notification to all contract providers that we will continue to evaluate utilization through the end of the fiscal year and underutilization will factor into decisions about their FY15 contract as well as the contract renewal that will take place in Fall 2015.

Prepare for the start of FY15 and explore taking down slots from providers that have been consistently underperforming. Consider using these extra slots to create a flex pool that all providers can access (similar to the supportive flex pool).

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Long-term Solutions Consider changing practices and policies to address concerns

with the waitlist, including: Invalid contact information which adds to the amount of

time providers spend sending out letters. Parents still on the waitlist even though they are enrolled in

another program. Waitlist families receiving multiple letters. Families no longer being eligible.

All contracts will be up for renewal in Fall 2015. Over the course of the next year, begin to craft a comprehensive plan for how to approach that contract renewal. Initiatives could include: Wide scale removal of slots from underperforming

providers. Reallocation of slots based on performance and need, but

also consider geographic distribution of slots.

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Current Status of Providers Contacted

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Vendor*

Regular Slots

Awarded 12/31/13

Regular Slots

Awarded 2/27/14

Regular Slots Used

12/31/13

Regular Slots Used

2/27/14

% Regular Slots Filled

12/31/13

% Regular Slots Filled

2/27/14

Total Slots

Awarded 12/31/13

Total Slots

Awarded 2/27/14

Total Slots Filled

12/31/13

Total Slots Filled

2/27/14

% Total Slots Filled

12/31/14

% Total Slots Filled

2/27/14

1 17.0 17.0 0.0 0.0 0.00% 0.00% 18.0 18.0 0.0 0.0 0.00% 0.00%2 12.0 12.0 0.0 0.0 0.00% 0.00% 13.0 13.0 0.0 0.0 0.00% 0.00%3 10.0 10.0 0.0 0.0 0.00% 0.00% 12.0 12.0 0.0 0.0 0.00% 0.00%4 22.0 7.0 3.0 3.0 13.64% 42.86% 24.0 9.0 3.0 3.0 12.50% 33.33%5 16.0 16.0 4.0 5.0 25.00% 31.25% 17.0 17.0 4.0 5.0 23.53% 29.41%6 8.0 8.0 2.0 2.0 25.00% 25.00% 11.0 11.0 2.0 2.0 18.18% 18.18%7 48.0 48.0 18.0 21.0 37.50% 43.75% 52.0 52.0 18.0 21.0 34.62% 40.38%8 26.0 26.0 10.0 10.0 38.46% 38.46% 30.0 30.0 10.0 10.0 33.33% 33.33%9 13.0 13.0 5.0 5.0 38.46% 38.46% 15.0 15.0 5.0 5.0 33.33% 33.33%10 117.0 117.0 49.0 53.0 41.88% 45.30% 123.0 123.0 49.0 53.0 39.84% 43.09%11 83.0 83.0 39.0 53.0 46.99% 63.86% 87.0 87.0 39.0 53.0 44.83% 60.92%12 20.0 20.0 9.5 11.0 47.50% 55.00% 21.0 21.0 9.5 11.0 45.24% 52.38%13 80.0 80.0 41.0 37.0 51.25% 46.25% 84.0 84.0 41.0 37.0 48.81% 44.05%14 58.0 58.0 30.0 26.0 51.72% 44.83% 61.0 61.0 30.0 26.0 49.18% 42.62%15 520.0 520.0 271.0 307.0 52.12% 59.04% 547.0 547.0 271.0 307.0 49.54% 56.12%16 46.0 46.0 25.0 26.0 54.35% 56.52% 48.0 48.0 25.0 26.0 52.08% 54.17%17 29.0 29.0 16.0 17.0 55.17% 58.62% 31.0 31.0 16.0 17.0 51.61% 54.84%18 55.0 55.0 31.0 32.0 56.36% 58.18% 58.0 58.0 31.0 32.0 53.45% 55.17%19 14.0 14.0 8.0 8.0 57.14% 57.14% 15.0 15.0 8.0 8.0 53.33% 53.33%20 12.0 12.0 7.0 8.0 58.33% 66.67% 14.0 14.0 7.0 8.0 50.00% 57.14%

Total 1,206.0 1,191.0 568.5 624.0 47.14% 52.39% 1,281.0 1,266.0 568.5 624.0 44.38% 49.29%

** Vendors highlighted in red have decreased the percent of slots filled** Vendors highlighted in green have increased the percent of slots filled* Vendors highlighed in orange have said that we can take down some of their slots.