1. EEC RESIDENTIAL AND PLACEMENT UNIT OVERVIEW Board of Early Education and Care May 12, 2009

2. Foundation 102 CMR 3.00 is adopted in accordance with M.G.L. c. 28A, particularly §§ 9 through 13, which states the policy of state government to assure every child "a fair and full opportunity to reach his/her full potential." In order to fulfill its mandate as the agency responsible for licensing residential programs, the Office has developed specific standards for residential programs to provide this opportunity to the residents they serve. The nature and scope of 102 CMR 3.00 are based on the belief that every aspect of a program's operation affects the residents in its care. The philosophy, administrative policies, staff, physical facility and clinical, recreational, and educational services all contribute to a resident's everyday living environment, and should maintain a level of quality that promotes healthy development.

3. Rationale for Licensure 3.02(1): Definitions: Child. Any person under the age of 18 for part or all of a calendar year or under 22 with special needs. Child with special needs. A child who, because of a disability consisting of a developmental delay or an intellectual, sensory, neurological, emotional, communication, physical, specific learning or health impairment or combination thereof, is or would be unable to progress effectively in a regular school program. This may include, but not be limited to, a school age child with special needs as determined by an evaluation conducted pursuant to M.G.L. c. 71B, § 3, and as defined by the Department of Education in 603 CMR 28.00.

4. Residential and Placement Unit Organizational Chart Commissioner Sherri Killins Northeast Region Licensor Michael Curran Kelly Buckley, Residential and Placement Supervisor Dave McGrath, Deputy Commissioner of Field Operations Western Region Licensors Christine Burnett David Micka Central Region Licensors Michael Ginetti Richard Mucci Tim Keane, Residential and Placement Supervisor Southeast Region Licensors Miguel Ortega Kathy Perry Metro Boston Region Licensors Kerry Murphy McCall Kara Adams

5. 406 Group Care Licenses Group Care Program: A program or facility that provides care and custody for one or more children by anyone other than a relative by blood, marriage or adoption on a regular 24-hour a day, residential basis.

6. 65 Temporary Shelter Licenses Temporary Shelter: Care and services (as appropriate to the needs of the child) provided to a child on a regular 24 hour a day basis for a period not to exceed 45 days or in the case of placement in a secure detention facility, not to exceed 90 days.

7. 51 Adoption Licenses Adoption: The establishment of the legal relationship of parent and child in accordance with the provisions of M.G.L. c. 210 et seq.

8. 83 Foster Care Licenses Foster Parent: An individual who provides temporary substitute parental care for a child or children under an agreement with a licensed or approved placement agency.

9. Licensor Caseloads/Responsibilities 2008 Calendar Year Unit Statistics Averages Per Licensor: Responsible for 70 providers/programs each Conducted over 31 licensing renewals each Opened 3 new and closed 4 licensed programs each Conducted over 80 complaint investigations each 46 investigations per licensor required follow up activity due to regulatory violations Reviewed quarterly restraint data and assured reporting compliance for 46 programs each Reviewed quarterly foster care suspected abuse/neglect data and assured reporting compliance for 9 programs each

10. R and P Unit Licensing Functions 1. Licensure of New Programs In person/phone consultation with perspective applicant Application submitted with 40 policies and procedures Licensor reviews 40 documents assuring compliance with regulations Written response/in person meeting relaying outstanding policy/procedure issues Schedule physical plant inspection Issue 6 month Provisional license Conduct 3 month monitoring visit Issue 2 nd six month Provisional license 2. Licensure of Current Programs 3 months prior to expiration, licensor sets up renewal visit and requests application Receive/Review application inclusive of updated policies, procedures and inspections Conduct visit to the facility (one to six days depending on the size/scope of services) Conduct Exit review/meeting Write and send review Review corrective action from program License renewal or other action taken

11. Licensing Functions Continued 3. Investigations Mandatory incidents and complaints (837 in 2008) Intake, collaborate, investigate and assure compliance (411 investigations resulted in citations) 4. Enforcement Follow-up on all complaint citations Monitoring visits Legal referrals Enforcement meetings 5. Technical Assistance Developing policy and TA papers Provide training and assistance to programs

12. Examples of Technical Assistance Licensors provide consultation and training on: The creation of behavior management policy and procedure Background Record Check policy and procedure Home Study development Internal investigations Program development

13. Other Responsibilities Include Conduct trainings for programs Attend and present to provider organizations Evaluate and produce feedback for the need for policy, procedure and regulation change Interagency meetings Internal meetings Internal/external committee involvement Regional duties and operations meetings

14. Collateral Work

15. Residential Care Population Served Includes but is not limited to: Learning disabled Autism and pervasive developmental disorders Behavioral disorders Eating disorders Sex offender/sexually reactive Criminal offender/adjudicated youth Severely physically disabled with limited life expectancy Schools for the deaf/hard of hearing, blind, etc.

16. Spectrum of Services Range from educational services for learning disabled children, through independent living skills for teen parents, to acute clinical and behavioral treatment for severely troubled children. Most of the children in residential facilities are there for treatment of emotional and behavioral issues that may include sexual and physical abuse and self-injurious behavior.

17. Challenge To build regulations in a meaningful way that support changes in: Spectrum of care Length of placement Diversity of program model

18. Melmark School

19. Hillcrest Educational Centers

20. Adoption Population Served Children birth to 18 Domestic Infant International Special Needs/Waiting Child Adoptive parents Birth parents

21. Spectrum of Services Domestic Infant: potential expectant parents make an adoption plan and choose a prospective adoptive family for their child International: prospective adoptive families are approved via a home study process and then enter an agency program where they are matched with a child Special Needs/Waiting Child: prospective adoptive families are matched with a child currently in foster care within a state system such as DCF Hague Adoption Convention Multilateral international treaty designed to protect children, birth families and adoptive families from unscrupulous practices, including hidden fees, bribery and child abduction Central authority is the US Department of State All US agencies working in international adoption must now be accredited through the Council on Accreditation 14 Massachusetts agencies have accreditation, 4 have full accreditation status.

22. Challenges Implementation of Hague has resulted in fewer infant adoptions and an increase in adoption of older, special needs children Adoption has become much more complicated, more expensive and a longer process for families and children Adoption practice and law is complex and largely unregulated in other states. Many Massachusetts adoptions are multi- state in process Impact and Change EEC has recently revised their home study policy to be more congruent with the time frames required by Hague and BCIS Adoption Advisory Group has met quarterly for over 5 years and consists of two supervisors, two licensors, two attorneys and 15 adoption agency directors Focus of the group is to identify tangible areas that need revision in the regulations, discuss trends in adoption and best practice concerns in Massachusetts

23. Foster Care Population Served Foster care agencies serve kids from birth up until the age of 22 Kids can have similar issues as those placed in residential program, but they require a less restrictive setting Many kids in foster care have been removed from their homes due to abuse/neglect issues

24. Foster Care Spectrum of Services The agencies hold EEC licensure not individual homes Homes are directly overseen and supervised by foster care agencies such as DCF, Mentor and Dare Ensures that agencies are in compliance with regulations regarding the supervision and oversight of their homes Oversight of the administrative operations of foster care agencies

25. Challenges Regulations need to be updated to reflect current practice Lack of potential foster homes/parents Although there is one set of regulations for both foster care and adoption, they could be broken into sections for easier understanding

26. DARE Family Services

27. Current Challenges Economy Professional development of work force in facilities and foster homes Restraint reduction Technological advances great for time management and supervision In the wrong hands can be used neglectfully Staying current with ever changing adoption law/practice Impact of vacant/ positions Detecting areas of overlap with other agencies Regulation revision

28. Regulation Revision for Residential and Placement Services Residential Current regulations lack the flexibility to withstand changes is program design Assessment of restraint regulations with eye toward early detection training to avoid restraint Cross walk with other agencies to assure alignment and minimize duplication Placement Address regulatory inconsistency with Federal Hague Adoption Convention Improve regulatory language relative to adoption related expenses/fees

29. Questions? Thank You