Transcript Organizational Capacity Assessment
New Provider Residential Services Orientation
State of Georgia Orientation 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
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”
• • • • • • 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
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
Georgia’s Priority of Placement
1. Family 2. Relative 3. Friend 4. Adoption 5. Foster Care – public sector 6. Private sector foster care 7. Private sector group homes
Organizational Capacity Assessment
Board Development
(Those who are accountable for the organization)
Truism
-
Board.
An organization is as strong as its
– 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 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
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
Grants for Startup
Fundraising
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 Max WO SBWO $29.02
$40.07
$45.00
SMWO SMFWO $69.00
$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 Child Care
Child Care Licensing Rhonda James ( [email protected]
) 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 regulations
Licensure
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
B r e a k
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
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
Services Purchased
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
Services Purchased
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 Infolrmation – FY12
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
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
The New RBWO Provider Application Information FY12 icon also includes helpful reference resources for review and downloading All documents reference 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
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 Regional Placement Specialists NW, NE, SW, SE 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
process.
-- Licensing allows an agency to provide out-of-home services. Within the rules of Licensing, each agency develops their own application •
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