New Provider Residential Services Orientation State Orientation of

New Provider Residential Services Orientation State. Orientation of Georgia 1

Introduction • What We Will Do - Educate • Presented By – Georgia Association of Homes & Services for Children (GAHSC) – Department of Human Services (DHS) • Office of Residential Child Care (ORCC) • Office of Provider Management (OPM) – Department of Juvenile Justice (DJJ)

Who Should Attend Applicants for the Licensing of: • Child Caring Institution – (Group Homes) • Outdoor Child Caring Programs • Child Placing Agency (Foster Care, Adoptions) • Children Transition Care Centers (CTCC) Orientation 3

Who Should NOT Attend Day Care Center Operators Foster Parent wantabe’s Adult Personal Care Home Applicants Psychiatric Hospital Applicants Maternity Homes Applicants Insect Exterminators Applicants Beauty Shop Operators Applicants Road Contractors Applicants Orientation 4

Overview Normer Adams Executive Director Georgia Association of Homes & Services for Children www. gahsc. org normer@gahsc. org 404 572 6170

Steps to Provision of Services Presentation Organization 1. Organizational Capacity and Needs Assessments 2. Licensure 3. Contracting with the State 4. Referrals and Payments

Steps to Provision of Services Step one - Organizational Capacity and Needs Assessments

FIRST PRIORITY Develop the “BUSINESS PLAN” The Plan vs. Good Intentions -Board -Budgets -Constituency -Facilities -Legal Issues -Policies & Procedures Organizational Capacity Assessment

FIRST PRIORITY THE BUSINESS PLAN (continued) • Research – The Need – The Competition • Interviews • Field Trips Needs Assessment

FIRST PRIORITY What will I be When I grow Up? Child Placing Agency– An agency that recruits, supports and places children in foster homes Child Caring Institution – Group home or other congregate care environment where facilities are built for the placement and care of children. Outdoor Child Caring Programs – Programs using a wilderness model for care and treatment of children. Needs Assessment

FIRST PRIORITY What will I be When I grow Up? Child Placing – An agency that recruits, supports and places children in foster homes • • First placement priority for state. 75% of all foster children go into this placement. Lowest cost per day per child Regulations require that they be not-for-profit. You can not own them, profit from them or sell them. Needs Assessment

FIRST PRIORITY What will I be When I grow Up? Child Caring Institution – Group home or other congregate care environment where facilities are built for the placement and care of children. • This is last placement choice for children with basic needs. • DFCS is not issuing any new contracts for this service • Only 14% of all foster children are placed in these facilities. Needs Assessment

FIRST PRIORITY What will I be When I grow Up? Outdoor Child Caring Programs – Programs using a wilderness model for care and treatment of children. • These are wilderness programs for children. • Most are considered treatment facilities. • Few of these facilities are being used for placement. • Requires over 500 acres in land. • State very reluctant to contract with new providers. Needs Assessment

FIRST PRIORITY What License should I get? Child Placing / Foster Care • Private Family centered Child Care • Few Capital Costs • Labor Cost follow Labor needs • Higher Reimbursement to Cost ratio • Higher Percentage of children entering care • Required to be “Not-for. Profit” Needs Assessment Child Caring Institution / Group Homes • Campus focused Child Care • High Capital Costs • Labor cost do not follow labor needs • Lower Reimbursement to Cost ratio • Lower percentage of children entering care • No requirement for “not-forprofit. ”

Board Development (Not-for-Profit Only) Should you be a Not-for-Profit (501 c 3)? For-Profit Not-for-Profit • Personal profit and benefit • Personal management • Ownership of assets • Risk of own resources • Community ownership and control • Community support though contributions • Risk of community resources Organizational Capacity Assessment

Georgia’s Priority of Placement 1. 2. 3. 4. 5. 6. 7. Family Relative Friend Adoption Foster Care – public sector Private sector foster care Private sector group homes Organizational Capacity Assessment

Board Development (Those who are accountable for the organization) Truism - An organization is as strong as its Board. – Choose people who can help you – Go beyond friends and family – Movers and Shakers of community make good Board Members Organizational Capacity Assessment

Executive Director (He/She who manages the organization) • Choose person of experience, integrity, responsibility and history • He/She will represent your organization • He/She will carry out your policies and procedures Organizational Capacity Assessment

Budgets and Budgeting Budget Development Expenses Income • Staff--Base Pay • Benefits • Insurance--Property, Casualty, & Liability • Food • Clothing • Transportation • Other • State Fees • Contributions-nonprofit only Organizational Capacity Assessment – Charity gifts – Grants – Endowments

Budgets and Budgeting Medical Care Covered by Medicaid – Nearly all children in residential care qualify for Medicaid. Organizational Capacity Assessment

Fundraising Grants for Startup List of all the Foundations and Charities that give to new organizations starting children homes and group homes. Organizational Capacity Assessment

Fundraising Grants for Startup All Foundations and Charities: 1. 2. 3. Organizational Capacity Assessment

Fundraising Grants for Startup • Very Few • Only to Existing Groups • Need 501(c)(3) status – Not-for-Profit • Anticipate 18 months for startup support • Build constituency Organizational Capacity Assessment

Not-for-profit Organization (Nearly all are 501(c)3) • Internal Revenue Service (IRS) Regulations for securing tax deductible contributions • Takes at least 1 year to secure • A knowledgeable person can do it without lawyer Organizational Capacity Assessment

Your Facilities • Fire Inspection - # 1 Problem Area – Most Expensive to Correct – State Regulations, County Interpretations and enforcement Organizational Capacity Assessment

Your Facilities Truism- If Community Support starts off negative, walk away. It will never turn positive. • Community Support - # 2 Problem Area – Build Support Carefully – If negative, hard to overcome – Use community leaders to lead Organizational Capacity Assessment

Your Facilities Zoning – The “Tip Off” to the Community -- Required before Licensing -- Zone for “a licensed childcare institution for six or more unrelated children” -- Movers and Shakers of community can help with this Organizational Capacity Assessment

Policies & Procedures (Provides the why and how of the organization) Truism – If your director can not explain them, they should not be your director. • Get a person who has done residential child care to prepare your policies and procedures • These are your rule books for operations • You will live and die by them • They become your Bible for operation Organizational Capacity Assessment

Technical & Clinical Assistance (Gut instinct is not enough. ) Truism – Education and Experience is more valuable than gut instinct. • A compliant child may be a depressed child. • An attentive, indulgent staff may be a pedophile. • Money in your pocket may not mean money in the bank. • Your High School Joe might like your facility as coed, but you won’t. Organizational Capacity Assessment

Staff & Personnel Issues (They make or break your organization) Truism - Your program is as good as your worst staff. • A thorough background check is essential. • “Would you let these folks care for your child? ” Organizational Capacity Assessment

Reporting Requirements Truism – God Forgives but the State never Forgets • Child Abuse Reporting Requirements • Stuff will happen! Self-report. • The law requires you to report abuse and neglect. • Do not even THINK of not reporting. • Preserve your relationship with State by dealing with integrity. Organizational Capacity Assessment

Working with the State • Some Steer The State is our partner in caring for children. Their role is regulatory and contractual. Respect it. • Others Row Our role is providing services to children. Together we work to provide the best care for children. Organizational Capacity Assessment

Budgeting/Rate Setting Truism – Child Welfare programming makes for a bad business investment. Georgia’s regulations prohibit any organization from making money. Your daily per diem will be the lesser of your costs or the maximum rate. Organizational Capacity Assessment

Budgeting/Rate Setting Truism – If you are doing it for the kids, then the money will come. • Funding remains the top priority for any administrator! • Without money, nothing happens. • The State is your number # 1 customer, and quite often, your only customer! • In Georgia, there are only a hand full of For-Profit agencies. (There is a reason for this. There is no profit in child welfare!) Organizational Capacity Assessment

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CCIs - Group Homes Base AWO MWO 2 nd Chance Teen Development Maternity home $101. 82 $128. 98 $181. 84 $162. 91 $108. 21 $101. 82 Organizational Capacity Assessment

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CPAs – Child Placing Agencies – Fixed Payment to Agency Traditional $21. 44 Base WO $29. 02 Max WO $40. 07 SBWO $45. 00 SMWO $69. 00 SMFWO $81. 00 Organizational Capacity Assessment

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CPAs – Child Placing Agencies – Payment to Foster Parent based on age of child 0 -5 years of age 6 -12 years of age 13+ years of age $14. 60 $16. 50 $18. 80 Organizational Capacity Assessment

Departments & Divisions of State Agencies

DHS Office of Residential Care Child Care Licensing Rhonda James (rjames@dhr. state. ga. us) 2 Peachtree Street, Atlanta, GA 30303 404 -657 -5589 http: //ors. dhr. georgia. gov/portal/site/DHR-ORS

Steps to Provision of Services Step Two - Licensure

DHR Office of Regulatory Services Child Care Licensing • License Categories: – CPA – Child Placing Agency - Placement of children in foster and or adoptive homes; domestic and international placement and home Study Services. – CCI – Child Caring Institutions or group homes 6 or more residents 6 -18 years old. – CTCC-Children’s Transition Care Center—medically fragile children. Short-Term (1 -14 days); Long-Term (90 -days) – OCCP – Outdoor Child Caring Program - Wilderness Camps – Maternity Homes (MATH)—home for pregnant mothers. – Determine which type of program you want to be. Licensure

How to Apply for Licensure 1. All CCIs & CTCCs MATH must obtain local zoning and fire approval before submitting an application 2. Download the licensure application package 3. Familiarize yourself with ORS rules and regulations--develop a working knowledge of the meaning and intent of these rules and regulations 4. Develop policies and procedures to address each rule 5. Prepare your agency for compliance with the Licensure regulations

Staff Qualifications for CCI • Director: Masters/2 years related experience or Bachelors/4 Years related experience • Human Services Professional (Social Services): Bachelors/2 Years Experience or supervised by Masters • Child Care Worker: 21 Years Old/ High School or GED • Director and owner both must document a satisfactory criminal records check. Licensure

Staff Qualifications for CPA • Director: Bachelors/2 Years related experience unless doing clinical supervision of staff • Case Work Supervisor (Social Services): Qualified Masters/2 Years CPA experience • Case Worker: Bachelors degree • Director and Owner must document a satisfactory criminal records check Licensure

Staff Qualifications for CTCC • Director: Master’s Degree or Higher in Nursing, Social Work or other Health Related field plus two years of experience working with medically fragile children; or • A licensed registered nurse, physician, other licensed health care professional with at least five years of experience working with medically fragile children. Licensure

Staff Qualifications for CTCC (cont. ) • Human Services Professional: Bachelors Degree in social work with two years experience or a master’s degree or be a licensed LPN or registered nurse. • There shall be one awake RN or other staff on duty at all times when children are present who is trained in first aid and has a current CPR certificate. Licensure

Criminal Records Check Law • Must be in compliance with Criminal Records Checks Law. • If employee’s check reveals any crime, person cannot be hired until resolved. • Must submit Live Scan and application to Office of Investigative Services for clearance. Licensure

Physical Plant for CCI 1. Water/Sewage 2. Bedrooms: 63 Square Feet per resident (double occupancy). 75 Square Feet (Single) 3. Bedrooms – must document space capacity to serve at least six residents. Not to exceed 16 4. Bathrooms – one sink/toilet per 8 kids, 1 shower per 10 kids. 5. Separate bathroom for staff. 6. Staff may not enter into a resident bedroom to access the bathroom. 7. SAFETY FIRST--Inside and Outside Licensure

Physical Plant for CCTC 1. Water/Sewage 2. Bedrooms: 63 Square Feet per resident (double occupancy). 75 Square Feet (Single) 3. Bedrooms – must document space capacity to serve at least six residents 4. Bathrooms – one sink/toilet per 6 kids. 5. 1 shower per 6 residents. 6. Separate bathroom for staff. 7. Staff may not enter into a resident bedroom to access the bathroom. Licensure

PHYSICAL PLANT CCTC (CONT) • All centers serving a child or children dependent on a wheel chair or other device for mobility shall have: • At least two exits, remote from each other, accessible to child with easily negotiable ramps. • All doorways and halls shall accommodate wheelchair access. • At least one bathroom of sufficient size to accommodate a wheelchair and assisting staff. Licensure

Behavior Management • Develop behavior management policies and procedures. • Policies should address behavior management techniques for type of children served. • A behavior management plan must be documented in the resident’s service plan. Licensure

Behavior Management (cont’d) • • • Develop policies and procedures on emergency safety interventions Emergency safety means those behavioral interventions techniques that are authorized under and an approved emergency safety intervention ESI’s are to only be utilized by properly trained staff in an urgent situation to prevent a child from doing immediate harm to self or others. Licensure

Waivers & Variances • The department at its discretion may grant a waiver or variance of specific rules upon application being filed. • Variance may be granted by upon showing by the applicant that a particular rule or regulation would cause undue hardship. • A waiver may dispense entirely with the enforcement of a rule or regulation upon showing that the purpose of the rule or regulation is met through equivalent standards. Licensure

Regulatory Process • Self-Assess for Rule Compliance and Completed Application Materials • Submit Application with all local approvals if required • Initial On-Site Inspection – Office Conference for CPA’s: Temporary License (12 Months) • Annual Re-Licensing Inspections • Follow-Up Inspections • Complaints/Self-Reported Incidents Licensure

LICENSURE • Obtaining a license throught the office of Residential Child Care does NOT guarantee a contract with other state departments to serve children and adolescents. Licensure

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Steps to Provision of Services Step Three - Contractual Process for Providers

Division of Family & Children’s Services DFCS The Office of Provider Management 404 -657 -3572 http: //www. dfcs. dhr. georgia. gov/portal/site/DHR-DFCS/

New RBWO Provider Application Process q The RBWO Provider process is handled through the Department of Families and children Services (DFCS) Office of Provider Management (OPM) q The process applies to agencies seeking to obtain a RBWO Provider contract as a Child Placing Agency (CPA) or Child Caring Institution (CCI) q Agencies seeking a RBWO Provider contract with DFCS must have an applicable CCI or CPA license from the Office of Residential Child Care Services Purchased

New RBWO Provider Application Process q As of 7/1/11, the start of FY 2012, The Office of Provider Management has revamped the provider application process § Revised provider applications are closely aligned with the FY 2012 RBWO Minimum Standards § The revised application process now includes an online New provider Self-Assessment § New Provider application requests will be based on specific services and locations identified on the Current RBWO Provider Service Needs List Services Purchased

New RBWO Provider Application Process q. Information about the application process is now available online at www. gascore. com q. Once on the home page of the website, click on the New RBWO Provider Application Infolrmation – FY 12 icon (the third posting listed in the News and Events section on the left side of the home page) Services Purchased

New RBWO Provider Application Process q Interested providers should review the applicable New Provider Information Sheet, which outline the process step-by step § New CCI Provider Information Sheet § New CPA Provider Information Sheet Services Purchased

New RBWO Provider Application Process q The New RBWO Provider Application Information FY 12 icon also includes helpful reference resources for review and downloading q All documents reference on the CCI and CPA New provider Information Sheets are available online: § FY 2012 RBWO Provider Service Needs List § FY 2012 RBWO Minimum Standards for CPAs and CCIs § DHS Map of Counties by Region Services Purchased

New RBWO Provider Application Process After reviewing the New Provider Application Process Information online, interested providers with questions should contact: The Office of Provider Management Main Office (404) 657 -3572 Services Purchased

DJJ Department of Juvenile Justice DIVISION OF COMMUNITY Services and Intake Community Services and Intake (404)-508 -6500 Patricia Lavalais (404) 508 -5087 www. djj. state. ga. us

Department of Juvenile Justice Division of Community Programs Serves to Protect the Citizens of Georgia by Providing Prevention Services, Court Services and Supervision, Treatment and Rehabilitation of Youthful Offenders. Approval Process of Vendors

DJJ Contract Application Process · Upon Obtaining Licensure, Contact the Residential Placement Specialist (RPS) in the District in which Your Facility is Located · Potential Provider requests application package from the Residential Placement Specialist. · Completed Application is submitted to the Residential Placement Specialist. · Application is reviewed by Residential Placement Specialist and supervisor. Approval Process of Vendors

DJJ Districts and Regions

Residential Placement Specialists 4 DJJ Regions NW, NE, SW, SE Regional Placement Specialists 1. Richard Fox (NW) 2. Kim Settles and Curtis Washington (NE) 3. Jeffrey Bright and Ayrica Rhodes (NW) 4. Carl Harrison (SW) Approval Process of Vendors 5. Sue Riner (SE)

DJJ Contract Approval Process • Residential Placement Specialist (RPS) Conducts Site Visit • Assesses Willingness and Ability to Service Delinquent Youth – School Issues – Supervision • Contract Process Initiated Approval Process of Vendors

Characteristics of Children in DJJ’s Care • • • Average Age - 13 (range is from 8 -17) Mostly Males Most Common Offenses - Property & Status Oppositional - Lack Impulse Control Common Mental Health Diagnoses - Conduct Disorder, Depression, PTSD • Substance Abuse Issues Characteristics of Children

Services to Children in DJJ’s Care • During FY 2004 - 59, 000 and FY 2009 54, 753 youth were served by the Department of Juvenile Justice. Services Purchased

Private Placements Normer Adams, GAHSC

Private Placements Agency determines what services to sell (or give away) to the private individual or corporation (usually another state. ) The nature of these services is determined on the ability to provide those services within the Licensing framework and Approved Levels of Care. Services Purchased

Characteristics of Children in Private Placement • Determined by agency’s mission and ability to care for the child. • And Agency’s ability to serve Characteristics of Children

Private Placements • Client Application Process-- Licensing allows an agency to provide out-of-home services. Within the rules of Licensing, each agency develops their own application process. • Contract Approval Process -- There is no approval process save Licensure. Approval Process of Vendors and Marketing

Private Placements Referrals and Payments • Referrals - Referrals are made by private individuals or agencies or another state. This referral network is determined by the agency. • Payments - Payments are negotiated with each referring party. Referrals and Payments

Private Placements Referrals and Payments Most Private Placements are done on a charity basis unless the placement is done by another State. Referrals and Payments

In Conclusion: Steps to Provision of Services 1. Organizational Capacity and Needs Assessments 2. Licensure 3. State Approval Process for Vendors 4. Marketing to Referral Sources, DFCS, DJJ, Private Sector