1. Division of Family & Children Services (DFCS): Overview of Foster Care in Georgia Presenters: Sharon L. Hill, PhD, DFCS Division Director Clifford O’Connor, Deputy Director, Fiscal Carol Hall, Kenny A Project Director Date: December 12, 2013 Georgia Department of Human Services

2. Child Welfare Caseloads and Case Managers: 2008 to present SFY Average Cases Per Month Average Number of Case Managers 200830,3032,375 200929,3592,228 201024,7842,001 201120,8451,927 201222,0261,712 201323,6031,619 Note: Average number of cases include both Child Protective Services (investigations, family support and family preservations) as well as children in foster care and other placement cases (ICPC, Extended Youth Supportive Services and relative placements).

3. Children in Legal Custody of DFCS The chart reflects the number of children who were in DFCS custody at any time during the month.

4. DFCS Placement Responsibility (October 2013) Note: Placement cases include those in DFCS legal custody, Extended Youth Supportive Services, Relative Placements, and Interstate Compact for the Placement of Children (ICPC) cases.

5. Placement Type for Children in Care (N=7,768) Placement Type Percentage of Total in DFCS Custody DFCS Foster Home32.2% Child Placing Agency (CPA) Foster Home30.4% Child Caring Institution (CCI)17.8% Relative Placement16.5% Adoptive Home3.0% OtherLess than 1% Source: SHINES; based on the number of children in DFCS custody on December 9, 2013. Note: 48% of children in foster care are placed with private providers (CPA and CCI). Other placements include DJJ, ICPC, other resources, etc.

6. Georgia In Care Rates (FY13a) Georgia as a state has a lower in care rate than the National Average Data source: AFCARS public files, and Claritas Population Projections City of Atlanta

7. Georgia Entry Rates (FY12) Georgia statewide has a higher entry rate than the National Average Data source: AFCARS public files, available from NDACAN City of Atlanta

8. Extended Youth Supportive Services (Youth 18-21) Note: Chart reflects the number of youth 18 to 21 who remain in care.

9. Children Entering and Exiting Care by Month More children entered care in nine of the 12 months than exited.

10. Federal Outcomes Comparison: Alabama, Florida, Georgia, Kansas and Tennessee

11. Timeliness of Reunification: FFY2008-FFY2011 Exits to reunification in less than 12 months: Of all children discharged from foster care to reunification in the year shown, who had been in foster care for 8 days or longer, what percent was reunified in less than 12 months from the date of the latest removal from home? National median = 69.9% FFY2008FFY2009FFY2010FFY2011 Change (FFY08-FFY11) Alabama63.161.26467.14.0 Florida69.769.572.373.94.2 Georgia60.558.266.470.610.1 Kansas69.563.267.267.8-1.7 Tennessee73.072.678.277.04.0 Source: FY08-FY11 Child Welfare Outcomes Report Data (12/21/2012)

12. FFY2008FFY2009FFY2010FFY2011 Change (FFY08-FFY11) Alabama9.09.18.38.1-0.9 Florida8.18.07.9 -0.2 Georgia10.310.79.07.4-2.9 Kansas8.29.08.89.00.8 Tennessee7.17.46.56.8-0.3 Timeliness of Reunification: FFY2008-FFY2011 Exits to reunification, median stay: Of all children discharged from foster care to reunification in the year shown, who had been in FC for 8 days or longer, what was the median length of stay (in months) from the date of the latest removal from home until the date of discharge to reunification? National median = 6.5 months (lower score is preferable in this measure) Source: FY08-FY11 Child Welfare Outcomes Report Data (12/21/2012)

13. Timeliness of Reunification FFY2008-FFY2011 FFY2008FFY2009FFY2010FFY2011 Change (FFY08-FFY11) Alabama10.68.67.810.1-0.5 Florida13.215.114.115.42.2 Georgia7.93.56.18.91.0 Kansas8.17.48.88.40.3 Tennessee13.413.013.511.8-1.6 Re-entries to foster care in less than 12 months: Of all children discharged from foster care to reunification in the 12-month period prior to the year shown, what percent re-entered foster care in less than 12 months from the date of discharge? National median = 15.0% (lower score is preferable in this measure) Source: FY08-FY11 Child Welfare Outcomes Report Data (12/21/2012)

14. Timeliness of Adoption: FFY2008-FFY2011 FFY2008FFY2009FFY2010FFY2011 Change (FFY08-FFY11) Alabama14.021.018.116.12.1 Florida29.130.933.131.72.6 Georgia23.227.430.531.17.9 Kansas25.227.425.231.15.9 Tennessee36.636.037.131.8-4.8 Children in care 17+ months, adopted by the end of the year: Of all children in foster care (FC) on the first day of the year shown who were in FC for 17 continuous months or longer, what percent was discharged from FC to a finalized adoption by the last day of the year shown? National median = 20.2% Source: FY08-FY11 Child Welfare Outcomes Report Data (12/21/2012)

15. Achieving Permanency for Children in Foster Care for Long Periods of Time FFY2008FFY2009FFY2010FFY2011 Change (FFY08-FFY11) Alabama94.696.992.989.1-5.5 Florida92.590.791.991.0-1.5 Georgia91.592.592.694.93.4 Kansas88.389.087.189.41.1 Tennessee92.091.591.191.7-0.3 Exits to permanency for children with TPR (termination of parental rights): Of all children who were discharged from foster care in the year shown, and who were legally free for adoption at the time of discharge, what percent was discharged to a permanent home prior to their 18th birthday? A permanent home is defined as having a discharge reason of adoption, guardianship, or reunification (including living with relative). National median 96.8% Source: FY08-FY11 Child Welfare Outcomes Report Data (12/21/2012)

16. Overview of Recent Improvements Child Death Staffings Permanency Roundtables Educational Programming Performance-Based Placements Georgia Composites Every Child Every Month SHINES Lenses Centralized Intake Focus on Psychotropic Med Reduction/DHS Medical Director National Youth in Transition Database (NYTD) Teen Works Data Integrity Unit (SHINES)

17. Child Death Staffings The purpose of the staffing is to provide front line staff support, consultation and direction while assessing these types of cases. By staffing these cases at a time when the case is active and unfolding we have the potential to improve case practice, enhance case manager awareness, increase child safety and ensure agency accountability while providing child protective services to the community we serve. Another purpose is to gain as much information as possible about the circumstances surrounding a serious injury or child death and to provide a link between county staff and upper management so that pertinent information is available in a timely manner. DFCS began Child Death Staffings in January 2012. Child deaths where there are unknown or suspicious circumstances and/or the death has elements of neglect or abuse; AND DFCS had prior Child Protective Services (CPS) history within the last 5 years.

18. Manner of Child Deaths for Calendar Year 2013 (N=86) Sleep-related deaths account for the most ascribed as accidental.

19. Strategies to Improve Outcomes for Children Working with Department of Public Health to enhance data collection, tracking, information sharing and reporting of child death cases in Georgia. Developing a template to use in conducting live learning with county DFCS offices on serious injury and child death cases in order to improve decision- making and assessment of child safety. Providing consultation and support for counties on cases of child death and serious injury, frequently including the medical experts from Children’s Healthcare of Atlanta. Working with Georgia Bureau of Investigation to increase partnership in gathering child death information and utilizing their agency’s resources. Partnering with Children’s Healthcare of Atlanta in developing more in depth analysis of medically related deaths.

20. Every Child Every Month Ensures every child in foster care in Georgia receives a quality, service- focused visit every month from their case manager. Percent of children seen by a case manager each month they are in care has steadily increased from 51% in FFY 2007 to 99% in FFY 2012 (Federal Target is 90%).

21. Case managers record contacts with children and families – those receiving in- home and out-of-home services. All contacts are recorded on the Contact Detail page. To track performance and monitor timeliness, supervisors and county/regional leadership use LENSES, an Oracle reporting application. ECEM – Every Child Every Month – meet the federal standards for ECEM reporting.

22. Caseworker Visitation Compliance report allows managers to monitor performance over a six month reporting period. LENSES users can click on the Month hyperlink or graph bar to view regional performance. LENSES allows users to drill down to the caseworker view. At any point, users can click on the View Visitation Details hyperlink to view additional reporting details.

23. CRCT Outcomes for Children in Foster Care (2009-2010 School Year) Note: Based on information received from Georgia Department of Education and reflects all grade levels taking the CRCT. The beginning of a laser-focus on the educational outcomes of children in foster care.

24. Educational Programming, Assessment, and Consultation The EPAC Unit provides comprehensive academic support services focusing on improving educational outcomes and the academic achievement of children and youth, ages 5 to 17 in the custody of Georgia Division of Family and Children Services. EPAC services are supported through TANF funding and are initiated through case manager or CPS referrals. Upon initial placement into foster care, children and youth are referred to EPAC for a comprehensive diagnostic educational assessment and subsequently, are monitored for ensuring adequate academic progress. In FFY 2013 there were 5,013 School-Aged Foster Youth (K-12) in foster care; EPAC has provided services to 87% of them. EPAC works with approximately 230 tutors across the State.

25. Statewide Longitudinal Data System (Department of Education) What is the primary purpose of the Georgia SHINES and SLDS connection? To expediently attend to educational needs To improve educational stability To help prepare a brighter future for our children What are the benefits? Access to historical education information Indicator for SWD (student with disability) Academic performance trends — student specific Historical attendance data Access to standardized test scores Access to the unofficial transcript Assist with case planning

26. Examples of SLDS Information Our staff are able to view attendance trend for each child in foster care.

27. Example of SLDS Information

29. Future Enhancements Transition of Foster Children to Care Managed Organization (CMO) / Amerigroup Safety Panels External Review Teams Trauma-Informed Practice Protocol for Medically Fragile Youth Aging Out of Care

30. Kenny A. Consent Decree Overview: Duration of Decree How Are We Doing? Exit Strategies

31. Kenny A. Consent Decree Page 42 Section 19-A With respect to the State Defendants, this Consent Decree shall remain in effect until: (1)State Defendants are in substantial compliance with the final measures on all Outcome Measures in Section 15 of this Consent Decree simultaneously for three consecutive reporting periods; and, (2)A motion to terminate jurisdiction over this Consent Decree is approved by the Court.

32. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1st2nd3rd4th5th6th7th8th9th10th 11th12th13th14th 01) 95% of all investigations of foster children shall be commenced within 24 hours 95%91%87%85%86%90%97% 99%100%93%94%93%91% 02) 95% of all investigations of foster children shall be completed within 30 days 95%83%78%72% 76%84%90%66%55%77%82%81%75%73% 03) 99% of all investigations of foster children shall include timely face-to- face, private contact with the alleged victim 99%85%87%83% 88%97% 99% 93% 91%88%

33. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th 04) No more than 8.6% of all foster children entering custody shall have re-entered care <8.6% 9.3%9.6%9.2%9.1%6.5%4.8%9.7%11.1%9.6%8.6%8.7%9.7%9.4% 05) No more than 1.27% (1st),.94% (2nd),.57% (4th) of all children in foster care shall be the victim of substantiated maltreatment <0.57%0.54%0.81%0.92%1.01%0.90%0.55%1.06%1.17%0.63%0.42%0.41%0.58% 0.74% 06) 90% (2nd), 98% (4th) of all foster homes will not have an incident of corporal punishment 98% 100% 99%100% 99%98%99%100% 07) At least 70% (2nd), 95% (4th) of all foster children entering care shall have had a diligent search 95% 73% 93% 80% 94%95%96%TBD

34. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th 08a) 40% of children entering custody shall have positive permanency within 12 months 40% 45% 48%49%51%50%53%55%54% 55% 56% 08b) 74% of children entering (1) shall have met 8(a) or have had adoption, permanent legal custody or guardianship within 24 months 74% 50%53%56% 59%62% 61%62% 63% 09) 40% of "up to 24 month backlog pool," shall have positive permanency within 12 months 40% 49%20% 19%21%19% 24% 27%9%17%32% 10) 35% of "over 24 month backlog pool," shall have positive permanency within 12 months 35% 36%9% 14%15%10%16%18%23%9%6%11%17% 11) By 2nd RP, all children with a final TPR, 80% shall have adoptions finalized within 12 months 80% 74%70%69%70%69%68%50%54%59%67%84% 55%

35. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th 14) No more than 5% of adoptions shall disrupt within 12 months of finalization <5% 1%0% 1%0% 15) 80% (2nd), 95% (4th) of all foster children 15/22 months, shall have had either (1) TPR filed; (2) compelling reasons in the child's case record 95% 84%86% 92%95% 96%100%98%100%98%96% 16) 70% (2nd), 80% (4th) of all foster children shall be placed with all of their siblings 80% 73%72%84%69%79%81%79%81%94%74% 81%66% 17) 86.7% (2nd), 95% (4th) of all children shall have had 2 or fewer moves during the prior 12 months 95% 90%84%91%92%91%89%87%92%94%90%93% 18) 90% (2nd) of all children shall have had 2 or fewer DFCS placement case managers during the prior year in custody 90% 84%91%92%90%91% 92%85%84%88%92%89%87%

36. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th 19) 70% (2nd), 80% (3rd), 90% (4th) of all children placed in removal county or within a 50 mile radius 90% 88% 97%98%97%99%98%95%99% 98%97%95% 20a) 96.25% in-placement visit combined 96.25% 16%15%14%36%48%51%64% 97.8% 97.5%99%98.1% 20b) 96.25% child visits private, face-to-face 96.25% 98.3%99.1%98.1%99.4%99.1% 21) 85% parent-child visits when goal is reunification 85% 25%47%76%81%90% 87%88%87%86%90%95% 22) 90% (2nd) worker- caregiver visits 90% 39%45%52%60%68%75%82%80%98% 97%99%98% 23) 80% (2nd) visits between siblings 80% 19%21%24%39%34%50%56%52%92%95%94%95%

37. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1st2nd3rd4th5th6th7th8th9th10th11th12th13th14th 24) Rate of children discharged age 18 or order with educational achievement (Revised Baseline = 36%)[P14] 56% 34% 25% 47% 50% 58%49.1%40% 25) 85% (1st), 95% (2nd), 98% (4th) in placements that are in full approval and/or licensure status 98% 86% 88%96%97%99%98% 99% 26) 85% (2nd), 95% (4th) shall have applicable language in court orders to assess Title IV-E qualifications 95% 55%42%69%64%65%71%69%80%85%90%91%90% 27) 80% (2nd), 85% (3rd), 95% (4th) shall have 6-month case plan review OR, file a motion within 45 days 95% 70%33%46%63%81%80%77%71%92%87%88%87%95% 28) 95% (2nd) shall have a permanency hearing OR, file a motion with 45 days 95% 80%70%82%83%81%95%87%89%99%93%95%94%

38. Periods 1 – 14 Outcome Performance OUTCOMESGoal Reporting Periods 1 st 2nd3rd4th5th6th7th8th9th10th11th12th13th14th 29) No more than 5% (3rd) shall have a lapse in their legal custody within the prior 13 months <5% 30%3%5%4% 5%1% 0%3%4%0% 30) 80% (2nd), 85% (4th) shall not have any unmet medical, dental, mental health, education, or other service needs, according to the service needs documented in the child's most recent case plan 85% 74%77%57%54%75%72%68%69%77%78%75%78%74% 31) No more than 10% (2nd) shall be placed in foster homes that exceed the capacity limits <10% 8% 7%6%8%3%4%0%2% 1%2% ONE TIME MEASURES 12) 90% shall have had adoptions or legal guardianships finalized within six months 90%94% 13) 95% registered on exchanges, and have an individualized adoption recruitment plan or plan for legal guardianship within 60 days 95%30%

39. Kenny A: Exit Strategies Added a Kenny A. Strategic Team to implement strategies for outcomes not achieved. Developing a Kenny A. Dashboard to provide real-time data. Conducting bi-weekly internal meetings.

40. Kenny A: Exit Strategies Focusing on Supervision Using Research to Guide Strategy Development Establishing Work Teams for Specific Outcomes Conducting Statewide Training

41. Kenny A: Exit Strategies Strengthening partnerships with private providers. Developing new relationships with external constituents. Sustaining performance on outcomes already achieved.

42. Questions?