Municipal youth and family centres
A joint audit with municipal audit offices
We have audited the establishment of Youth and Family Centres (CJGs). Together with municipal audit offices we looked at how 42 municipalities had organised and funded their CJGs. We also investigated the cooperation within the network of care professionals. The municipal audit offices have issued their own reports to their municipal executives. Our report presents an overview of the results.
Conclusions
Municipalities and care professionals have invested a great deal of energy in establishing CJG drop-in centres in recent years. CJGs have been established in all municipalities. All the municipalities we audited had also made agreements on cooperation and the integration of care provision within the CJGs. But the fulfilment of these agreements is often still in its infancy. A lot still needs to be done regarding accountability for the agreements.
It cannot be said at present whether CJGs are working efficiently and effectively. There is no reference framework to make such an assessment:
- In many cases, few if any measurable terms have been formulated regarding the CJGs' precise tasks and the social effect the municipalities would like to achieve
- Since the municipalities do not have a good insight into the costs and expenditures incurred by CJGs, the costs of different CJGs cannot be compared with each other.
- CJGs currently hold few client surveys or public satisfaction surveys.
In many municipalities, children, young people and their parents are not yet sufficiently aware of the CJGs. Other points for improvement relate to the early warning function (timely recognition that a child has a problem) and care coordination (the coordination of care among the various health professionals). Both are less than optimal because inadequate use is made of the digital 'referral index for young people at risk'. The index can be used to identify which care professionals are in contact with a particular child. Furthermore, many municipalities do not involve all relevant partners in the early warning function and care coordination.
Many CJGs seem to be operating at present like multiple occupancy office blocks, in which every care professional thinks and acts in the interests of its own organisation and care domain. In general, there is no shared CJG identity. The CJGs therefore do not have the added value they should have. To fulfil their gatekeeper function in the new youth care system, the CJGs should pay attention to these points.
Recommendations
We recommend that the State Secretary for Health, Welfare and Sport (VWS) continue to work with the Association of Netherlands Municipalities (VNG) to promote and facilitate the transition towards the new youth care system. She could do so by, for example:
- compiling a guide, with terms and definitions, in order to promote a 'shared language' among CJGs;
- organising dedicated public information campaigns and publicising success stories;
- analysing and addressing information exchange between care professionals in and around the CJGs;
- insisting on the rapid introduction of performance indicators and providing support for information management at the CJGs;
- developing a financial framework with related accounting instruments.
The special purpose grants for Youth and Family Centres were converted in 2012 into a form of decentralised funding. If the services to be provided by the CJGs are laid down in law, local authorities will also be responsible for their provision and the state secretary will have to report to the House of Representatives on the operation of the system. We recommended that the state secretary explain to the House and the municipalities what information will be required and how it should be provided.
Response
The State Secretary for VWS and the VNG responded to our audit on 30 May and 6 June 2012 respectively. They stressed that the proposed Youth Care Act would require every municipality to provide a recognisable and low-threshold form of youth care. The law will not lay down, however, how the CJGs must be organised.
In response to our recommendations, the state secretary observed that:
- a dictionary is currently being compiled;
- care professionals require ongoing training in data protection legislation so that they can take well-considered decisions on the exchange of information;
- performance indicators are being prepared and support is being organised for information management at the CJGs;
- a study is being carried out of how to help municipalities design their costing models.
The VNG will adopt our recommendations in its policy on CJGs and it agrees with the state secretary's observations.