New Provider Residential Services Orientation State 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) 2

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) 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 4

Georgia Association of Homes & Services for Children Overview Normer Adams Executive Director Georgia Association of Homes & Services for Children www.gahsc.org normer@gahsc.org 404.572.6170 5

Steps to Provision of Services Presentation Organization 1. Organizational Capacity and Needs Assessments 2. Licensure 3. Contracting with the State 4. Referrals and Payments 6

Steps to Provision of Services Step one - Organizational Capacity and Needs Assessments 7

Organizational Capacity Assessment FIRST PRIORITY Develop the “BUSINESS PLAN” The Plan vs. Good Intentions -Board -Facilities -Budgets -Legal Issues -Constituency -Policies & Procedures Organizational Capacity Assessment 8

THE BUSINESS PLAN (continued) FIRST PRIORITY THE BUSINESS PLAN (continued) Research The Need The Competition Interviews Field Trips Needs Assessment 9

What will I be When I grow Up? 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 10

What will I be When I grow Up? 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 11

What will I be When I grow Up? 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 12

What will I be When I grow Up? 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 13

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” 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-for-profit.” Needs Assessment 14

Board Development (Not-for-Profit Only) Should you be a Not-for-Profit (501 c 3)? For-Profit Personal profit and benefit Personal management Ownership of assets Risk of own resources Not-for-Profit Community ownership and control Community support though contributions Risk of community resources Organizational Capacity Assessment 15

Georgia’s Priority of Placement Family Relative Friend Adoption Foster Care – public sector Private sector foster care Private sector group homes Organizational Capacity Assessment 16

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 17

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 18

Budgets and Budgeting Budget Development Expenses Staff--Base Pay Benefits Insurance--Property, Casualty, & Liability Food Clothing Transportation Other Income State Fees Contributions-nonprofit only Charity gifts Grants Endowments Organizational Capacity Assessment 19

Organizational Capacity Assessment Budgets and Budgeting Medical Care Covered by Medicaid – Nearly all children in residential care qualify for Medicaid. Organizational Capacity Assessment 20

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 21

Organizational Capacity Assessment Fundraising Grants for Startup All Foundations and Charities: 1. 2. 3. Organizational Capacity Assessment 22

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 23

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 24

Organizational Capacity Assessment Your Facilities Fire Inspection - # 1 Problem Area Most Expensive to Correct State Regulations, County Interpretations and enforcement Organizational Capacity Assessment 25

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 26

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 27

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 28

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 29

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 30

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 31

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 32

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 33

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 34

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. CCIs - Group Homes Base $101.82 AWO $128.98 MWO $181.84 2nd Chance $162.91 Teen Development $108.21 Maternity home $101.82 Organizational Capacity Assessment 35

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 36

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 $14.60 6-12 years of age $16.50 13+ years of age $18.80 Organizational Capacity Assessment 37

Departments & Divisions of State Agencies 38

DHS Office of Residential Child 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 39

Steps to Provision of Services Step Two - Licensure 40

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 41

How to Apply for Licensure All CCIs & CTCCs MATH must obtain local zoning and fire approval before submitting an application Download the licensure application package Familiarize yourself with ORS rules and regulations--develop a working knowledge of the meaning and intent of these rules and regulations Develop policies and procedures to address each rule Prepare your agency for compliance with the regulations Licensure 42

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 43

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 44

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 45

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 46

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 47

Physical Plant for CCI Water/Sewage Bedrooms:63 Square Feet per resident (double occupancy). 75 Square Feet (Single) Bedrooms – must document space capacity to serve at least six residents. Not to exceed 16 Bathrooms – one sink/toilet per 8 kids, 1 shower per 10 kids. Separate bathroom for staff. Staff may not enter into a resident bedroom to access the bathroom. SAFETY FIRST--Inside and Outside Licensure 48

Physical Plant for CCTC Water/Sewage Bedrooms: 63 Square Feet per resident (double occupancy). 75 Square Feet (Single) Bedrooms – must document space capacity to serve at least six residents Bathrooms – one sink/toilet per 6 kids. 1 shower per 6 residents. Separate bathroom for staff. Staff may not enter into a resident bedroom to access the bathroom. Licensure 49

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 51

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 52

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 53

Self-Assess for Rule Compliance and Completed Application Materials 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 54

LICENSURE Obtaining a license through the office of Residential Child Care does NOT guarantee a contract with other state departments to serve children and adolescents. Licensure 55

B r e a k 56

Steps to Provision of Services Step Three - Contractual Process for Providers 57

New Provider Orientation Presenter: C. Richardson, DFCS, Office of Provider Management Presentation to: GAHSC Provider Orientation Date: October 11, 2012 Georgia Department of Human Services

Vision, Mission and Core Values Stronger Families for a Stronger Georgia. Mission Strengthen Georgia by providing Individuals and Families access to services that promote self-sufficiency, independence, and protect Georgia's vulnerable children and adults. Core Values Provide access to resources that offer support and empower Georgians and their families. Deliver services professionally and treat all clients with dignity and respect. Manage business operations effectively and efficiently by aligning resources across the agency. Promote accountability, transparency and quality in all services we deliver and programs we administer. Develop our employees at all levels of the agency.

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

New RBWO Provider Application Process As of 7/1/11, the start of FY2012, The Office of Provider Management has revamped the provider application process Revised provider applications are closely aligned with the FY2012 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

New RBWO Provider Application Process Information about the application process is now available online at www.gascore.com Once on the home page of the website, click on the New RBWO Provider Application Information - FY12 icon (this is a posting in the News and Events section on the left side of the home page)

New RBWO Provider Application Process Interested providers should review the applicable New Provider Information Sheet, which outlines the process step-by-step New CCI Provider Information Sheet New CPA Provider Information Sheet

New RBWO Provider Application Process The New RBWO Provider Application Information FY12 icon also includes Helpful reference resources for review and downloading All documents referenced on the CCI and CPA New Provider Information Sheets are available online: FY2012 RBWO Provider Service Needs List FY2012 RBWO Minimum Standards for CPAs and CCIs DHS Map of Counties by Region

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

Approval Process of Vendors 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 66

Community Services and Intake (404)-508-6500 DJJ Department of Juvenile Justice DIVISION OF COMMUNITY Services and Intake Community Services and Intake (404)-508-6500 www.djj.state.ga.us 67

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 68

DJJ Districts and Regions 69

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) 5. Sue Riner (SE) Approval Process of Vendors 70

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 71

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 72

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 73

Private Placements Normer Adams, GAHSC 74

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 75

Characteristics of Children 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 76

Approval Process of Vendors and Marketing 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 77

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 78

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 79

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 80