Children’s Passport Planning Project: Cost Benefit Analysis
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISChildren’s Passport Planning Project: Cost Benefit AnalysisTable of Contents1Overview and Methodology . 1-12Alternative 2: Estimated DDI Costs and Projected Benefits . 2-13Alternative 3: Estimated DDI Costs and Projected Benefits . 3-14Breakeven Analyses & Summary . 4-1List of ExhibitsExhibit 2-1: Alternative 2 Estimated DDI Costs. 2-2Exhibit 2-2: Alternative 2 Projected Benefits . 2-3Exhibit 2-3: Summary of Alternative 2 Projected Quantitative Benefits . 2-7Exhibit 3-1: Alternative 3 Estimated DDI Costs. 3-2Exhibit 3-2: Alternative 3 Projected Benefits . 3-3Exhibit 3-3: Summary of Alternative 3 Projected Quantitative Benefits . 3-7Exhibit 4-1: Alternative 2 Cost Benefit Profile . 4-2Exhibit 4-2: Alternative 2 Breakeven Analysis . 4-3Exhibit 4-3: Alternative 3 Cost Benefit Profile . 4-4Exhibit 4-4: Alternative 3 Breakeven Analysis . 4-5Table of ContentsPage i
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS1Overview and MethodologyOverviewAs part of its approved State Systems Interoperability and Integration Grant application,the New York State Office of Children and Family Services (OCFS) proposed the completion ofsix (6) major tasks designed to encompass a planning project to support the future design,development and implementation (DDI) of a New York State Children’s Passport (CP), anelectronic record information technology (IT) system that will store multi-agency (State andFederal) data associated with youth in OCFS custody. The initial phase of this initiative willfocus on creation of an interoperable electronic record aggregating health information for NewYork State’s foster care (FC) population. To gather this data, OCFS will work with the NYDepartment of Health (DOH) to establish a bi-directional information sharing capability focusedon the timely aggregation of Medicaid claims and encounter information as children enter fostercare settings.These tasks and associated deliverables include:1. As-Is Assessment of the Business Processes, Data Sources and TechnicalArchitecture Supporting the Foster Child (FC) Health Information Environment2. Alternatives Analysis3. Cost Benefit Analysis4. Finalization and Justification of the Selected Alternative5. Definition of Benefits to Other States6. Monthly Progress and Final Project ReportingThis document presents deliverable 3, a Cost Benefit Analysis (CBA) designed tocompare the costs and benefits associated with alternatives 2 and 3 detailed in deliverable 2Alternatives Analysis. For each of these alternatives, estimated costs, projected qualitative andquantitative benefits and a breakeven analysis are presented to support deliverable 4 Finalizationand Justification of the Selected Alternative.Alternatives under consideration include:1. Design, development and implementation of new child welfare and health businessprocesses and supporting information technology systems to capture the most currentfoster care children’s health information (alternative 2); and,2. Integration and enhancement of existing child welfare and health business processes andsupporting information technology systems to capture the most current foster carechildren’s health information (alternative 3).Please note that in the Alternative Analysis deliverable it was determined that alternative1, enhancement of existing child welfare and health business processes and supportinginformation technology systems to capture the most current foster care children’s healthinformation with no multi-agency integration, failed to address the minimum Children’s Passportsystem requirements. As a result, alternative 1 is not included in this Cost Benefit Analysis.Overview and MethodologyPage 1-1
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISMethodologyOCFS incorporated guidance provided by the Federal Department of Health and HumanServices, Administration for Children and Families (DHHS-ACF) Feasibility Alternatives andCost Benefit Analysis Guide located feasibilty alternatives and cba guide.pdf todevelop this deliverable.Qualitative and quantitative benefits associated with each alternative are identified anddescribed along with estimated DDI costs and projected benefits over an eight (8) year period.Estimated costs are compared to projected quantitative benefits to complete a breakeven analysisto identify the most viable strategy. Analysis and summary of breakeven results will be used tosupport deliverable 4 Finalization and Justification of the Selected Alternative.Overview and MethodologyPage 1-2
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS2Alternative 2: Estimated DDI Costs and Projected Benefits2.1Alternative 2 OverviewUnder this alternative new child welfare and health business processes will be definedand implemented along with new supporting information technology systems necessary tocapture the most current foster care children’s health information. A total of four concurrentsystems development efforts across three organizational units (OCFS, the Office of Temporaryand Disability Assistance (OTDA) and DOH) must be planned and coordinated. This alternativewill not address the issue of multi-agency integration.2.2Summary of Alternatives AnalysisWhile alternative 2 meets the minimum requirements of the Children’s Passport systemand the project’s targeted outcomes, its technical feasibility is questionable.While replacement business processes and IT systems will be based on new technology,operational silos will remain. The migration path from development to production will be highlycomplex and introduce a high level of risk. Based upon previous attempts to replace thesesystems, implementing this alternative will be costly and will take a minimum of five years.While alternative 2 offers the latest technical innovations available, the potential toleverage other state’s innovations and the opportunity to improve business processes, it will bevery costly, take a longer time to market and will not fully address the issue of implementingdata standards.2.3Alternative 2 Estimated DDI CostsCost estimates for this alternative were extrapolated from a combination of historical datagleaned from previous initiatives attempted to replace these IT systems and experience withsimilar large scale system development efforts. They are presented by Federal Fiscal Year (FFY)and are limited to design, development and implementation (DDI) tasks.Estimated DDI costs were derived as follows: MMIS replacement DDI cost estimates are based on procurement efforts completed over thelast several yearsWMS replacement DDI costs are based on a combination of efforts to replace the systemover the past 8 years and a comparison with the complexity of the MMIS effort. MMISreplacement DDI cost estimates were doubled to derive WMS replacement DDI costestimatesCONNECTIONS/CCRS replacement DDI cost estimates are based on recent efforts tomigrate to a new technology platformMDW replacement DDI cost estimates are based upon historical data to implement theapplication over the past several yearsEstimated operational costs will be addressed in subsequent Advance Planning Document(APD) submissions as required.Alternative 2Page 2-1
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISExhibit 2-1Alternative 2 Estimated DDI CostsSUMMARY OFESTIMATED DDI COSTSAlternative 2WMS ReplacementYear 1FFY 2014Year 2FFY 2015Year 3FFY 2015Year 4FFY 2016TOTALPROJECTYear 5FFY 2017 128,000,000 128,000,000 128,000,000 128,000,000 128,000,000 640,000,000CONNECTIONS/CCRSReplacement 25,000,000 25,000,000 - 50,000,000MMIS Replacement 80,000,000 80,000,000 - 320,000,000MDW Replacement 75,000,000 75,000,000 - 150,000,000TOTALAlternative 2 308,000,000 308,000,00080,000,000- 208,000,000 80,000,000- 208,000,000 128,000,000 1,160,000,000Page 2-2
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS2.4Alternative 2 Projected BenefitsSince children in foster care have more extensive, complex health care needs than theirpeers, they account for a somewhat higher share of public health spending. In order to improvehealth outcomes, it is also necessary to share health care information in a timely manner. Accessto this information supports the care planning and coordination of services necessary to stabilizeand improve the overall health of foster care children.By developing and implementing an electronic capability such as the Children’s Passportto aggregate and provide access to health care information across multiple state agencies, wemove closer to the reality of real-time coordination of care between health professional and othercaretakers of the foster care population. This coordination capability will support the followingqualitative and quantitative benefits.Exhibit 2-2Alternative 2 Projected BenefitsBenefit TypeQualitativeAlternative 2BenefitProgram & Policy Supporting business processes across 3 organizational units will beanalyzed and reengineered to more adequately support programoperations A common database structure will defined and developed, representinga wholesale redefinition of all impacted human service program data New business processes and IT systems will support improved captureof foster care children’s health information Despite the lack of full multi-agency integration of systems and healthdata, this alternative will facilitate and support, to a limited extent:o overall improvement of the quality of health care servicesprovided to children in foster careo New York State’s Medicaid Redesign Team (MRT) initiatives totransition foster care children covered by Medicaid to aManaged Care Model and the leveraging of care coordinationcapabilities facilitated by the Children’s Passport.o improved State and Voluntary Agency (VA) oversight of servicedelivery and program administration for the foster carepopulation and reduction of the administrative burdeno improved coordination of services via access to managementdata necessary to evaluate usage patterns and clinical outcomeso prevention of dangerous drug interactionso improved prescribing, monitoring and oversight of psychotropicmedication use in the high-risk, high-cost population of childrenPage 2-3
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISBenefit TypeBenefitin foster careo improved insight into and monitoring of the use of psychotropicmedications and polypharmacyo the promotion of the meaningful use of electronic health recordsby New York State’s Medicaid providers and the FederalElectronic Health Record Incentive ProgramInformation TechnologyQuantitative Provides the latest available technical innovationsSupports the potential to leverage other State’s innovations Reduction in placements in environments more restrictive than may berequiredReduction in the use of psychotropic medications Calculating Quantitative BenefitsAlternative 2 proposes the wholesale replacement of all related legacy systems andincludes the development and implementation of a common database structure supporting OCFS,OTDA and DOH human services programs.However, since this alternative does not directly address full multi-agency integration, itwill support the following, projected quantitative benefits, to a limited extent: Reduction in placements in environments more restrictive than may be requiredReduction in the use of psychotropic medications by the foster care population.Projections for these quantitative have been developed by examining New York Statespecific data as well as data provided by the Wraparound Milwaukee 1 and Texas HealthPassport 2 programs.Reduction in Placements in Environments More Restrictive than May Be RequiredWraparound Milwaukee is a managed care program serving the needs of children andadolescents experiencing severe mental health issues. Electronic records are used to integratemedical and mental health information. These records can be accessed by the program’s networkof child psychiatrists and primary health care providers. Common access to this information hasresulted in improvements in the coordination of care, including a 78.6% reduction in the rate ofresidential treatment for children and youth in care.1B. Morrow, Electronic Information Exchange: Elements that Matter for Children in Foster Care (Santa Monica,CA: The Children’s Partnership, 2013) 4.2GAO, Foster Care State Practices for Assessing Health Needs, Facilitating Service Delivery, and MonitoringChildren’s Care (GAO-0926) (Washington, DC: US Government Accountability Office, 2009) 33.Alternative 2Page 2-4
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISIn order to project similar quantitative benefits for the New York State (NYS) foster carepopulation, the following calculations were completed:Step 1: Calculate the total annual cost of care for NYS’s foster care population using theinstitutional payment type 1,075,655 total institutional days in care in 2010 3 302.20 average cost per day for the institutional payment type 4 1,075,655 days in care X 302.20 average cost per day 325,062,941 - total annual cost ofcare for NYS’s foster care population using the institutional payment typeStep 2: Apply the Wraparound Milwaukee rate of reduction of 78.6% 325,062,941 total annual cost X 78.6% 255,499,472 projected annual savingsStep 3: Calculate 50% of this totalTo account for differences in program structure and time required to glean the full benefitassociated with access to electronic health information, 50% of the projected annual savings isascribed as a quantitative benefit. 255,499,471 projected annual savings X 50% 127,749,736 projected annual savingsascribed as a quantitative benefitReduction in the Use of Psychotropic MedicationsTo project a quantitative benefit for a reduction in the use of psychotropic medicationsfor the New York State (NYS) foster care population, results from the Texas STAR HealthProgram were evaluated. As part of this program, Texas has implemented the nation’s mostextensive web-based health record system, the Health Passport, to serve its population ofapproximately 30,000 children and youth in foster care. (Please note that Texas data has beenused since their foster care population is close to NYS’s population of 20,000 children andyouth in foster care).3http://nysccc.org/wp-content/uploads/Maps New York State 2010.pdf s/ 1112 RATE CHART (Foster Care) July 1 2011 - June 302012.pdf4Alternative 2Page 2-5
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISAccording to GAO Report 122705 5, Texas spent 194,952,105 in 2008 to providepsychotropic medications to its non-foster care and foster care populations. Approximately 36%of this total covers the Texas foster care population or an annual expenditure of 70,182,758.As a result of implementing their Health Passport, Texas officials reported a 20%decrease in foster care psychotropic drug use 6.Using Texas Health Passport data, a 20% reduction in a total annual expenditure resultsin the following projected annual savings:Step 1: Apply the Texas Health Passport rate of reduction of 20% 70,182,758 X 20% 14,036,552 annual reduction in expenditures on psychotropicmedications for children in foster careStep 3: Calculate 50% of this totalTo account for differences in program structure and time required to glean the full benefitassociated with access to electronic health information, 50% of the projected annual savings isascribed as a quantitative benefit. 14,036,552 projected annual savings X 50% 7,018,276 projected annual savings ascribedas a quantitative benefitExhibit 2-3 summarizes alternative 2 projected quantitative benefits. Please note thatthese benefits cannot be ascribed until year 6 when all DDI work is projected for df, 35.B. Morrow, Electronic Information Exchange: Elements that Matter for Children in Foster Care (Santa Monica,CA: The Children’s Partnership, 2013) 4.6Alternative 2Page 2-6
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISExhibit 2-3Summary of Alternative 2 Projected Quantitative Y2017Year5FFY2018Year 6Year 7Year 8FFY2019FFY2020FFY2021 - - - 127,749,736 127,749,736 127,749,736 383,249,208 1: Reduce Days inCare/Payment Type Institution -2: ReducePsychotropicMedication Costs - - - - - - - - - - 134,768,012Totals:Alternative 2 -Year3FFY20167,018,2767,018,276 134,768,012Totals7,018,276 134,768,01221,054,828 404,304,036Page 2-7
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS3Alternative 3: Estimated DDI Costs and Projected Benefits3.1Alternative 3 OverviewUnder this alternative existing child welfare and health business processes and supportingIT systems will be enhanced to capture the most current foster care children’s health informationand will be fully integrated across all impacted agencies. It will leverage the work completedimplementing the Children’s Passport for the Juvenile Justice population as well as workcompleted as part of the State’s Enterprise Architecture Program, Master Person Services Index(MPI) initiative.3.2Summary of Alternatives AnalysisAlternative 3 meets the minimum requirements of Children’s Passport system objectivesand the project’s targeted outcomes. It is technically feasible and promotes the implementation ofenhancements to legacy systems that will be fully integrated across OCFS, OTDA and DOH,meeting envisioned user requirements and system objectives.It is operationally feasible and will present minimal impacts to the operational pattern andresources of OCFS, OTDA and DOH. It is financially feasible, promoting an incrementalinvestment in new technologies while not impacting ongoing legacy operations.Alternative 3 provides a shorter time to market, the latest technical innovations available,an opportunity to leverage existing applicable functionality (e.g., Children’s Passport for the JJpopulation and the MPI initiatives), an opportunity to enhance technical architecture (e.g.,Service Oriented architecture (SOA) and Enterprise Service Bus (ESB)), an opportunity tostandardize data sources (i.e., X12 standards), and an opportunity to integrate data silos (e.g.,initial integration: child welfare and Medicaid/health data).While part of the proposed technology solution will remain in the legacy technicalarchitecture and staff with skills in new technologies may be required, this alternative remainsviable.Alternative 3Page 3-1
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS3.3Alternative 3 Estimated DDI CostsCost estimates for this alternative were based on historical data gleaned from previousinitiatives completed to enhance the CONNECTIONS Child Welfare system and experience withsimilar large scale system development efforts. Please note that the scope of cost estimates islimited to design, development and implementation (DDI) tasks. Estimated operational costs willbe addressed in subsequent Advance Planning Document submissions as required.Exhibit 3-1Summary of Alternative 3 Estimated DDI CostsSUMMARY OFESTIMATEDDDI COSTSAlternative 3CONNECTIONSEnhancementsYear 1FFY 2014 Alternative 314,000,000Year 2FFY 2015 14,000,000Year 3FFY 2015 Year 4FFY 2016- TOTALPROJECTYear 5FFY 2017- - 28,000,000Page 3-2
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS3.4Alternative 3 Projected BenefitsThis alternative proposes the DDI of a Children’s Passport system that will support avastly improved foster care children’s health care coordination capability. This capability willsupport the following qualitative and quantitative benefits.Exhibit 3-2Alternative 3 Projected BenefitsBenefit TypeQualitativeBenefitProgram and Policy Facilitates overall improvement of the quality of health care servicesprovided to children in foster careSupports New York State’s Medicaid Redesign Team (MRT) initiativesto transition foster care children covered by Medicaid to a ManagedCare Model and leverages the care coordination capabilities facilitatedby the Children’s Passport.Supports State and Voluntary Agency (VA) oversight of servicedelivery and program administration for the foster care population andreduces the administrative burdenSupports prevention of dangerous drug interactionsFacilitates coordination of services and provides management data toevaluate usage patterns and clinical outcomesSupports improvements in prescribing, monitoring, and oversight ofpsychotropic medication use in the high-risk, high-cost population ofchildren in foster careSupports improved insight into and monitoring of the use ofpsychotropic medications and polypharmacySupports the promotion of the meaningful use of electronic healthrecords by New York State’s Medicaid providers and the FederalElectronic Health Record Incentive ProgramInformation Technology Alternative 3Provides the latest technical innovations available, supporting a path tothe eventual upgrade of the overall technical architectureProvides the opportunity to leverage existing applicable functionality ofthe Children’s Passport for the Juvenile Justice population and theMaster Person Index initiativeProvides Service Oriented Architecture (SOA) and Enterprise ServiceBus (ESB) features easily leveraged to support related initiativesProvides the opportunity to standardize data sources (i.e., X12standards)Page 3-3
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISBenefit TypeQuantitativeBenefit Provides the opportunity to integrate data silos, with an initialintegration of child welfare and Medicaid claims/health data Shorter time to market saves DDI costsShorter time to market also brings quantitative benefits to fruition 4years earlier thereby dramatically improving the cost benefit ratioReduction in placements in environments more restrictive than may berequiredReduction in the use of psychotropic medications Calculating Quantitative BenefitsAlternative 3 proposes the enhancement of legacy systems with full multi-agencyintegration and will fully support the following quantitative benefits: Reduction in placements in environments more restrictive than may be requiredReduction in the use of psychotropic medications by the foster care population.Projections for these quantitative have been developed by examining New York Statespecific data as well as data provided by the Wraparound Milwaukee 7 and Texas HealthPassport 8 programs.Reduction in Placements in Environments More Restrictive than May Be RequiredWraparound Milwaukee is a managed care program serving the needs of children andadolescents experiencing severe mental health issues. Electronic records are used to integratemedical and mental health information. These records can be accessed by the program’s networkof child psychiatrists and primary health care providers. Common access to this information hasresulted in improvements in the coordination of care, including a 78.6% reduction in the rate ofresidential treatment for children and youth in care.In order to project similar quantitative benefits for the New York State (NYS) foster carepopulation, the following calculations were completed:Step 1: Calculate the total annual cost of care for NYS’s foster care population using theinstitutional payment type 1,075,655 total institutional days in care in 2010 9 302.20 average cost per day for the institutional payment type 107B. Morrow, Electronic Information Exchange: Elements that Matter for Children in Foster Care (Santa Monica,CA: The Children’s Partnership, 2013) 4.8GAO, Foster Care State Practices for Assessing Health Needs, Facilitating Service Delivery, and MonitoringChildren’s Care (GAO-0926) (Washington, DC: US Government Accountability Office, 2009) 33.9http://nysccc.org/wp-content/uploads/Maps New York State 2010.pdf (19)Alternative 3Page 3-4
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSIS 1,075,655 days in care X 302.20 average cost per day 325,062,941 - total annual cost ofcare for NYS’s foster care population using the institutional payment typeStep 2: Apply the Wraparound Milwaukee rate of reduction of 78.6% 325,062,941 total annual cost X 78.6% 255,499,472 projected annual savingsStep 3: Calculate 50% of this totalTo account for differences in program structure and time required to glean the full benefitassociated with access to electronic health information, 50% of the projected annual savings isascribed as a quantitative benefit. 255,499,471 projected annual savings X 50% 127,749,736 projected annual savingsascribed as a quantitative benefitReduction in the Use of Psychotropic MedicationsTo project a quantitative benefit for a reduction in the use of psychotropic medicationsfor the New York State (NYS) foster care population, results from the Texas STAR HealthProgram were evaluated. As part of its program, Texas has implemented the nation’s mostextensive web-based health record system, the Health Passport, to serve its population ofapproximately 30,000 children and youth in foster care. (Please note that Texas data has beenused since their foster care population is close to the NYS population 20,000 children and youthin foster care).According to GAO Report 122705 11, Texas spent 194,952,105 in 2008 to providepsychotropic medications to its non-foster care and foster care populations. Approximately 36%of this total covers the Texas foster care population or an annual expenditure of 70,182,758. Asa result implementing their Health Passport, Texas officials reported a 20% decrease in fostercare psychotropic drug use 12.Using Texas Health Passport data, a 20% reduction in a total annual expenditure resultsin the following projected annual reRates/ 1112 RATE CHART (Foster Care) July 1 2011 - June df, 35.12B. Morrow, Electronic Information Exchange: Elements that Matter for Children in Foster Care (Santa Monica,CA: The Children’s Partnership, 2013) 4.Alternative 3Page 3-5
NEW YORK STATE OFFICE OF CHILDREN AND FAMILY SERVICES (OCFS)STATE SYSTEMS INTEROPERABILITY AND INTEGRATION PROJECT GRANT # 90FQ0005CHILDREN’S PASSPORT PLANNING PROJECT: TASK 3: COST BENEFIT ANALYSISStep 1: Apply the Texas Health Passport rate of reduction of 20% 70,182,758 X 20% 14,036,552 annual reduction in expenditures on psychotropicmedications for children in foster careStep 3: Calculate 50% of this totalTo account for differences in program structure and time required to glean the full benefitassociated with access to electronic health information, 50% of the projected annual savings isascribed as a quantitative benefit. 14,036,552 projected annual savings X 50% 7,018,276 projected annual savings ascribedas a quantitative benefitExhibit 3-3 summarizes alternative 3 projected quantitative benefits.
Cost Benefit Analysis (CBA) designed to compare the costs and benefits associated with alternatives 2 and 3 detailed in deliverable 2 . Alternatives Analysis. For each of these alternatives, estimated costs, projected qualitative and quantitative benefits and a breakeven analysis are presented to support deliverable 4 . Finalization
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