AB 12 Informational Convening

Placement & Licensing Breakout Session

Placement & Licensing: Outline of Today’s Presentation

   Overview placement options for NMDs Focus on changes/new placements     THP-Plus FC SILP Group Homes THPP Placement Topics • Shared Living Agreement • • Placement and Reentry Fingerprinting • • • Placement Agreement Relative Approval Grievance Process  Licensing Interim Standards

Where are Older Youth in Placed in Foster Care?

2,985 18 year-olds as of April 1, 2011

Foster Home; 6% THPP; 3% Other, 10% Kin; 19% Runaway, 11% Guardian, 13% FFA; 19% Group Home, 19%

Placement All County Letter & Interim Licensing Regulations

  ACL 11-77 – Extension of Foster Care Beyond Age 18: Part Two (Placement) available at: http://www.dss.cahwnet.gov/lettersnotices/ent res/getinfo/acl/2011/11-77.pdf

Community Care Licensing – interim regulations for Non-Minor Dependents in Foster Care available at: http://ccld.ca.gov/PG2802.htm

General Guidance on Placement Decisions from ACL 11-77

 “It is expected that NMDs will be provided placements that are the least restrictive and encourage as much independence as possible, based on the NMDs’ developmental needs and readiness for independence.”  “Decisions regarding continuation of current placements or moves to new placements shall be made in consultation with the NMDs.”

Placement Settings

  Traditional placement options still available to NMDs including:  Approved home of relative or NREFM       Certified home of an FFA (includes ITFC) Foster Family Home Group Home (with limitations) Home of a Nonrelated Legal Guardian Small Family Home/Dual Agency Regional Center Homes THPP (with limitations) 2 NEW Placement Options for NMDs:  THP-Plus Foster Care  Supervised Independent Living (SILP)

Group Homes for NMDs

 Decision on group home placement is to be a youth-driven, team-based case planning process  Youth can remain in group home if under age 19 AND continuing in group home is in NMDs best interest in order to complete high school or equivalent  Once NMD completes high school or turns 19, whichever is first, continuing in a group home is prohibited UNLESS  NMD has a medical or mental health condition (participation condition #5)   and continuing in group home functions as a short-term placement; Treatment services to alleviate the medical condition cannot be sole basis for disqualification from group home (Ex: youth is seriously emotional disturbed and is in therapeutic day treatment); Treatment strategies should prepare NMD for discharge to a less restrictive and more family-like setting.

Case Plan for Group Home Placements

 For group home placements, the case plan must specify      Why a group home is the best placement to meet the needs of the NMD; How this placement will assist the NMD’s transition to independent living; The treatment strategies that will be used to prepare the NMD for discharge to a less restrictive setting or more family like setting; A target date for discharge from the group home; Periodic review of the placement to ensure that it remains the best option for the NMD and progress is being made toward achieving the goal of independent living.

Transitional Housing Placement Program

 Youth can continue to participate in THPP after age 18 and up to age 19:  In order to complete high school or equivalency prior to age 19; OR  In order to complete the high school year prior to age 19

New Supervised Independent Living Settings

Supervised Independent Living Settings

THP-Plus Foster Care Supervised Independent Living Placement

THP-Plus Foster Care

  Modeled after existing THP-Plus program WHY?

   Measurable youth outcomes 9,188 youth served in last five years Experienced network of 60 providers in 51 counties  THP-Plus will continue to serve three categories:    Youth between ages of 21 and 24; Youth under age 21 who do not want to participate in extended care; Youth who do not meet one of five participation conditions

For more information, visit www.thpplus.org

THP-Plus vs. THP-Plus FC

HOW THEY ARE THE SAME HOW THEY ARE DIFFERENT

 Provide youth a comprehensive range of supportive services, including educational, vocational & social support.  Affordable housing in three settings:    Scattered site (62%) Single-site (25%) Host home (13%)  Intensive case management:  1 to 12 for non-parents  1 to 8 for parents  Similar monthly rates (~ $2,500/mo)  Neither licensed by Community Care Licensing  Both will have flat rate  THP-Plus FC is a IV-E eligible placement  Court supervision  Child welfare or probation oversight  Providers will pay fees to county for approval process  More comprehensive criminal background clearance for providers  Will use different data systems  Different program durations  Serve different ages   THP-Plus: 18 to 24 THP-Plus FC 18 to 20

Status of THP-Plus Foster Care

      THP-Plus FC ACL on County Plan Requirements is final Future ACLs to cover approval standards and rates Two rates proposed: one for site-based; one for host family Parenting NMD’s receive the Infant Supplement and if in host family model, may be eligible for the WFFH Shared Responsibility Plan rate in addition Unclear how 70/30 split will operate under realignment NOTE from ACL : Beginning January 1, 2012, foster youth who have reached age 18 and want to participate in extended care have the option to do so as long as they meet all applicable program requirements. Even if THP-Plus-FC is not available as a placement option on January 1, 2012, the NMD can remain in the current placement or the county can place the NMDs, as appropriate, in one of the other placement options

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Supervised Independent Living Placement

Intended for NMDs who are developmentally ready to live independently NMDs responsible for finding their own SILP unit; SILP must be approved by county No service provider/no caregiver/least restrictive placement Settings may include, but are not limited to:  Apartment living (alone or with roommates)  Single room occupancies   Renting a room Dorms/university housing  living situations which include adult siblings, appropriate extended family members, tribal members, NREFM or mentors should be explored

SILP Rate

 Limited to basic rate (currently $776.00/month)  NMD may receive the foster care benefit directly  Clothing allowance available  Parenting NMDs receive the Infant Supplement.  Specialized care increment not available

Two-Part SILP Process

 Readiness Assessment  SILP Inspection: Checklist of Facility Health and Safety Standards  NOTE: College dorms, or other designated university housing not subject to SILP inspection and NMD does not have to have a readiness assessment prior to residing in a college/university setting

SILP Readiness Assessment

 Readiness assessment is required; no standard tool  If no permanent connection not on site, assessment must take into account youth’s level of skill and ability to manage this least restrictive setting  Assesses whether or not the NMD is developmentally ready to handle daily tasks on their own, such as:     Preparing meals Budgeting Managing money Paying bills

SILP Readiness Assessment

 Examples of reasons for denial:  Rent and utilities exceed income  Unstable income  No knowledge of how to manage money  Unable to care for self without assistance due to a medical or mental health condition  If assessment determines NMD is not ready for a SILP, areas of improvement should be turned into goals in their TILP  Reason for denial should be documented on the assessment and provided to NMD  If NMD disagrees, he/she has the right grievance process

Approval of SILP Unit

 10-item SILP inspection checklist is completed by SW/PO  Two kinds of deficiencies: 

Immediate denial

: Running water, heat, electricity, fire escapes, and be free from hazards such as exposed electrical wires, black mold, and insect or rodent infestations.

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Issues that need repair

: Neglect of maintenance of the building and grounds, cracked window(s), peeling wallpaper, or stained walls or flooring, Inoperable sink or shower

University/College Approved Housing is exempted from the checklist

Other SILP Information

 Denied unit does not mean a NMD may not be placed in a SILP, just not that SILP  Copy of completed checklist should be provided to NMD  NMDs allowed to live in an unapproved SILP temporarily  SILP unit must be re-inspected annually  County must inspect new SILP within 10 calendar days  SILP Approval and Placement Agreement sent to FC EW  SILP may not include living with biological parent

SILP Roommate Selection

 Given SILP rate, likely that NMD will require a roommate  Roommates and landlords do not need to be assessed (no background check required)  Important for discussions between the NMD and the supervising agency and/or case managers to help the youth reach a responsible decision

Making Placement Decisions and Supervision of Placements

Supervision of Placement

 Monthly face-to-face visits with Social Worker/PO   Federal regulations require a majority of supervision to be in the residence of the child Efforts should be made to respect the NMD’s privacy  NMDs sharing room with a minor  NMDs who remain in the same placement may continue sharing a room with a minor in the home.

 NMDs who change placements, the NMD may share a room with a dependent minor at the discretion of the case managers for both parties (exp. of situations where sharing a room may be appropriate: siblings, close in age)

Placement Agreements

 If a NMD remains in his or her current placement no new placement agreement is required  Any change in placement requires a pre-placement appraisal and new placement agreement  New Placement Agreement Forms have been developed and will be posted on CDSS website by January 1, 2012   SOC 152 Placement Agency – THP-Plus-FC Provider Agreement SOC 153 Placement Agency – FFA Agreement    SOC 154B Agency - Group Home Agreement SOC 156A Agency – Foster Parents Placement Agreement SOC 157A SILP Approval and Placement Agreement  SOC 157B SILP Inspection: Checklist of Facility Health and Safety Standards

Pre-Placement Appraisal

 Process which includes a conversation with the case manager and caregiver to  determine the needs of the NMD,  the ability of the caregiver to provide for those needs and  ensure the safety of everyone in the home  Not necessary for approved homes (such as relatives or NERFM)

Fingerprinting

 Youth remaining in care in the same placement attaining age 18 – no fingerprints.

 Youth who exit and re-enter – they may be fingerprinted only for the purpose of assessing the safety and appropriateness of placement in a facility that has minor dependents

Emergency Placements

 Emergency placements may be necessary for NMDs  Until regulations are developed, Manual of Policies and Procedures sections 31-410 (temporary placements) and 31-45 (emergency shelter care) apply  Group homes still subject to limitations

Shared Living Agreement

   Shared Living Agreements are a best practice SLA be negotiated between the NMD and provider/caregiver/roommate   Examples of what to include in SLAs Curfews (up to caregiver and NMD).

Overnight guests (caregiver could restrict it or allow it).

  Using kitchen and utensils.

(caregiver can’t restrict it as off limits but could have “no cooking past midnight” rules.) Allowances or passing along money for personal spending – it is not required but should be addressed in the Shared Living Agreement.

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Placement of NMDs Who Re-Enter

Placement in a licensed foster home where minors reside is allowed Pre-placement appraisal conducted County may elect background check for NMDs placed in homes with minors Placing agency has discretion to place prior to receipt of results based on results of appraisal Criminal record does not disqualify them from re entry Subsequent ACL on Re-Entry will be released soon

County Grievance Procedures

 Grievance process currently exists for relative approvals (not placement); defined in Division 31  Disputes arising around placement decisions – resolved through social worker, NMD and ultimately by the court  Other grievance processes around placements will be locally determined

Assembly Bill (AB) 12 Licensing Interim Standards

Identified “Big Ticket” Sections

 Definitions  Plan of Operation  Safeguards for Cash Resources, Personal Property, and Valuables  Reporting Requirements  Admission/Intake Procedures  Criminal Record Clearance

Identified “Big Ticket” Sections, cont’d.

 Removal or Discharge Procedures  Nonminor Dependents’ Records        Personal Rights Expectations, Alternatives, and Consequences Health-Related Services Food Service Responsibility for Providing Care and Supervision Activities Buildings and Grounds

Definitions, Plan of Operation & Records

Issue Guidance

Definitions Plan of Operation Records New definitions applicable to nonminor dependents (NMDs) Information to be included in Plan of Operation to address NMDs.

Control of records shared by caregiver and NMD.

Safeguards, Reporting & Criminal Record Clearance

Issue Guidance

Safeguards for Cash Resources, Personal Property, and Valuables Reporting requirements Control of these resources shifts from the caregiver to a NMD.

Criminal record clearance What is to be reported to licensing, placement agencies, and authorized representatives in regards to a NMD.

NMD not subject to criminal record clearance to be in a children’s residential community care facility.

Admission/Intake Procedures

 Process for the caregiver and a NMD regarding admission into a licensed children’s residential community care facility.  Appraisal of a NMD to address needs of a NMD, ability to meet needs, and compatibility of the NMD with the facility or home.

Removal or Discharge Procedures

   Reasons and procedures for removal/discharge of a NMD from a children’s residential community care facility in an emergency or non-emergency situation.

7 day prior written notice required for non emergency discharge Emergency removal includes  Removal by law enforcement officers when a NMD is arrested  Removal becomes necessary when the health and safety of the NMD or others in the home is endangered by the continued presence of the NMD  Removal for emergency medical or psychiatric care

Personal Rights

  Personal Rights that apply to a NMD, e.g.,  Allow NMD to acquire, maintain, and possess and use personal items.

 Acquire, possess and maintain vehicle  Select, obtain and store own food  Select, obtain or decline medical, dental, vision or mental health care  Adequate privacy for visitors  To be informed by caregiver of laws regarding complaints and confidentiality of complaints  Send/receive unopened mail  Acquire, possess and maintain landline or cellphone  Leave or depart the home at any time at NMD’s discretion Caregiver shall ensure NMD is verbally informed of these rights at time of placement and provided written information regarding agencies NMD can contact if rights are violated

Expectations, Alternatives, and Consequences

 Reasonable expectations for living in the facility or home with emphasis on reasonable alternatives and consequences for noncompliance with expectations.  A NMD is to participate in review based on needs.

 May use Shared Living Agreement as a Model

Responsibility for Providing Care and Supervision

 Caregiver to assist a NMD in developing skills necessary for self-sufficiency.

 Caregiver permitted to leave NMD in home alone, including overnight (up to 72 hours with no notice)  If longer then 72 hours, caregiver shall provide written or verbal notification to the social worker and get prior approval

Activities, Food & Health-Related Services

Issue Guidance

Activities Food Entitles a NMD to participate in activities of his or her own choosing Permits a NMD to have opportunity to plan and prepare meals as well as be provided with meals.

Heath-Related Services Caregiver responsibility for health-related services to a NMD, e.g., assistance to a NMD with self administration of medication.

Medical Confidentiality

   NMDs have all legal decision making authority as any other adult Privacy regarding medical conditions Federal requirement to include information about known medical problems/medications and other relevant health information applies to NMDs (must be documented in HELP)   Confidential, but must be provided to caregiver in licensed/approved setting Caregivers/providers required to keep all medical information confidential

Buildings and Grounds

 Permits a NMD to share a bedroom with a child or another NMD  Permits a NMD to have access to household items needed for cooking or cleaning.

Relative Approval Standards for NMDs

 Now that we have the draft of Article 3 of the CCL regulations, the process for relative approval for NMD’s needs to be correspondingly modified to meet the new Article 3 standards.

QUESTIONS?