Transcript TITLE PAGE

New Provider
Residential Services
Orientation
State of Georgia
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)
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
Overview
Normer Adams
Executive Director
Georgia Association of Homes
& Services for Children
www.gahsc.org
[email protected]
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-forProfit”
Needs Assessment
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-forprofit.”
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.
2.
3.
4.
5.
6.
7.
Family
Relative
Friend
Adoption
Foster Care – public sector
Private sector foster care
Private sector group homes
Organizational Capacity Assessment
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
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
Income
• Staff--Base Pay
• Benefits
• Insurance--Property,
Casualty, & Liability
• Food
• Clothing
• Transportation
• Other
• State Fees
• Contributions-nonprofit
only
Organizational Capacity Assessment
– Charity gifts
– Grants
– Endowments
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
Fundraising
Grants for Startup
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
$101.82
AWO
$128.98
MWO
$181.84
2nd Chance
$162.91
Teen Development
$108.21
Maternity home
$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
$29.02
Max WO
$40.07
SBWO
$45.00
SMWO
$69.00
SMFWO
$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
Organizational Capacity Assessment
$14.60
$16.50
$18.80
Departments & Divisions
of State Agencies
Steps to Provision of Services
Step Two - Licensure
New Provider Orientation
Presenter: Rhonda James, DHS—Office of Residential Child
Care
Presentation to: GAHSC New Provider Orientation
Date: Quarterly (2nd Tuesday of the Month)
Georgia Department of Human Services
Vision, Mission and Core Values
Vision
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.
DHS Office of Residential Child Care Services
• LICENSE CATEGORIES
• CCI--Child Care Institution also known as a group home.
• CPA--Child Placing Agency…foster care services and adoption (both
domestic and international)…Home study Only
• CTCC--Children Transition Care Center—medically fragile children.
• OCCP--Outdoor Child Caring Program—Wilderness Camp…requires
10acres of land per child.
• Maternity Homes/Second Chance Homes—home for pregnant mothers
and mothers and babies.
• Runaway and Homeless Youth Programs(RHYP)—a registered program.
• DETERMINE WHICH TYPE OF PROGRAM YOU WANT TO BE.
Applying for Licensure
• All CCI’s, CTCC’S. OCCP’S & MATH, RHYP—must obtain
local zoning and fire approval before submitting an
application.
• Download the application package @
www.ors.dhr.georgia.gov
• Familiarize yourself with ORS rules and regulations and
develop a working knowledge of the meaning and intent of
the rules.
• Develop policies and procedures to address each rule.
• Prepare your agency for compliance with the rules and
regulations.
STAFF QUALIFICATIONS FOR CCI
• Director—master’s 2-years of related experience or
Bachelor’s degree and 4-years of related experience.
• Human Services Professional—provides the case
management…bachelor’s degree approved field and 2years of experience or a master’s degree in approved field
of study.
• Child Care Worker—must be at least 21 years of age and
have a HS Diploma or a GED.
PHYSICAL PLANT FOR CCI
• Water/Sewage…If the home operates on a septic tank must
submit Environmental Health Inspection or copy of city
water bill.
• Bedrooms--63 sq.ft. per resident for double occupancy and
75 sq.ft. for single occupancy.
• Must document space capacity to serve at least six
residents not to exceed 16.
• Must document a food service permit if providing care for
thirteen(13) or more residents.
PHYSICAL PLANT FOR CCI (cont.)
• Bathrooms--one sink/toilet per 8 residents and 1 shower
per 10 residents.
• There must be a separate bathroom for staff.
• A staff member may not enter into a resident bedroom to
access the bathroom
• An initial on-site inspection is completed and observed for
SAFETY FIRST—INSIDE AND OUTSIDE.
STAFF QUALIFICATIONS FOR A CPA
• Director--must have a bachelor’s degree and 2-years of
related experience unless they are providing the clinical
case supervision.
• Case Worker Supervisor (Social Service) Master’s Degree
and 2-years of related experience in a CPA.
• Case Worker—Bachelor’s degree
• There are no physical plant requirements for a CPA.
STAFF QUALIFICATIONS FOR CTCC
• Director--Master’s degree or higher in nursing; social work
or other health related fields and two years of experience
working with medically fragile children.
• A licensed registered nurse, physician, other licensed
health care professional with at least five years of
experience working with medically fragile children.
Staff Qualifications for CTCC cont.
• Human Services Professional—bachelor’s degree in social
work with two years experience or a master’s degree.
• There shall be sufficient staff members on duty at all times
to assure each child proper care according to his/her
needs. When children are present at the center, there shall
be at least one awake RN on duty.
Physical Plant for CCTC
• Water/Sewage…If home operates on a septic tank must
submit Environmental Health Inspection or copy of city
water bill.
• Bedrooms--63 sq.ft. per resident for double occupancy and
75 sq.ft. for single occupancy.
• Bathrooms--one sink/toilet per 6 residents.
• One shower per 6 residents.
• Separate bathroom for staff.
Physical Plant for CCTC (cont.)
• Staff may not enter into a resident bedroom to access the bathroom.
• All centers serving residents dependent on a wheelchair 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
wheelchairs.
--At least one bathroom of sufficient size to
accommodate a wheelchair and assisting staff.
Maternity Home (Basic and Second Chance Services)
•
Maternity home--is an agency providing care within any six-month period, to more
than one (1) pregnant woman, either before, during or within two (2) weeks after
childbirth. Providing care to pregnant youths through 21 years of age. Services
are limited to eight weeks of services…unless providing Second Chance Home
Services.
•
Second chance home--means a licensed maternity home that provides full-time
residential care, support and supervision to pregnant and parenting youth through
21 years of age and their child(ren) that is expected to last for more than an eight
(8) week period following delivery. Program services include parenting skills, such
as child development, education, job training, transitioning to independent living,
family budgeting, health and nutrition, and other skills to promote residents’ longterm independence and the well-being of their child(ren).
Maternity Home (Basic and Second Chance Services)
•
The director must possess a Masters or RN Degree and two years of related
experience or a Bachelor’s Degree and four years of related experience.
•
The Human Services Professional (HSP) Must possess a Master’s Degree in social
work, psychology, childhood education, education counseling and psychology,
nursing or healthcare, or a related field or a bachelor's degree and either have two
(2) years experience in a field related to the type of residents served or be
supervised by another human service professional with a master's degree in one(1)
of the above disciplines.
•
There shall be at least one HSP for every 16 residents in care including the infants.
Maternity Home (Physical Plant)
•
The sleeping room shall not be less than 75 square feet per resident in single
rooms, and not less than 63 square feet per resident in multiple rooms
•
There shall be at least one (1) lavatory with hot and cold water, one (1) toilet and a
bathtub and/or shower for every four residents.
•
A nursery is not required by these rules, however, maternity homes that include
nurseries must meet the following additional requirements:
The nursery shall be large enough to allow a minimum of 30 square feet of floor
space and 300 cubic feet of air space per infant.
•
There shall be separate toilet and bath facilities for the residents and staff.
Runaway and Homeless Youth Programs
Effective July 1, 2011, ORCC is also authorized by law to
register Runaway and Homeless Youth Programs
(RHYP)
(O.C.G.A. § 49-5-160 et. seq.)
• Runaway and Homeless Youth Programs (RHYP) currently licensed child welfare agencies or 501(c)(3)
organizations that serve children under 18 years old who
have run away and/or are homeless.
Runaway and Homeless Youth Programs
• The agency must submit a description of the range of services
provided, the manner in which those services are provided to youth
and a statement that the Services that are provided to youth, are
limited to 72 hours.
• The agency must submit operational policies and procedures.
• Must have at least one staff member who is licensed.
• There is an annual registration fee of $25.
Criminal Records Check Law
• The director and owner of each license type must both document a
satisfactory criminal records check (fingerprints—live scan)
• All other employees must be in compliance with the law.
• If any employee’s check reveals any crime, person cannot be hired
until resolved and cleared through the Office of Inspector General’s.
• Any person acting in the absence of the director must meet the
qualifications of the director and document a satisfactory CRC.
Waivers & Variances
• The department at its discretion may grant a waiver or
variance of specific rules upon application being filed.
• A variance may be granted upon the applicant showing that
a particular rule or regulation would cause an 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 Process
• Self Assess for rule compliance and completed application
materials.
• Submit application with all necessary local approvals if
required. (zoning, fire inspection, CO, etc.)
• Initial on-site Inspection scheduled—an office conference
for a CPA. If approved, a Temporary License is issued for
12 months.
• Annual re-licensing inspections
• Follow-up Inspections
• Complaints/ Self-reported incidents
LICENSURE
•
Obtaining a license through the Office of
Residential Child Care does NOT guarantee a
contract with other state agencies or departments
to serve children and adolescents.
Break
Steps to Provision of Services
Step Three - Contractual
Process for Providers
New Provider Orientation
Presenter: Shaun Johnson, DFCS, Office of Provider
Management
Presentation to: GAHSC Provider Orientation
Date: Quarterly (2nd Tuesday of the Month)
Georgia Department of Human Services
Vision, Mission and Core Values
Vision
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
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
Department of Juvenile Justice
DIVISION OF COMMUNITY
Services and Intake
Community Services and Intake (404)-508-6500
www.djj.state.ga.us
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 - NW, NE, SW, SE
Regional Placement Specialists
1. Richard Fox (NW)
2. Ayrica Rhodes and Curtis Washington (NE)
3. Jeffrey Bright and Ayrica Rhodes (NW)
4. Carl Harrison (SW)
5. Sue Riner (SE)
Approval Process of Vendors
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-- 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
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