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New Provider Residential Services Orientation

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Title +New Provider Residential Services Orientation Author: Office Manager Last modified by: Normer Adams Created Date: 10/8/2007 8:54:16 PM Document presentation format – PowerPoint PPT presentation

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Title: New Provider Residential Services Orientation


1
New ProviderResidential Services Orientation
  • State of Georgia

2
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)
    Licensing
  • Division of Family and Children Services (DFCS)
  • Division of Behavioral Health and Developmental
    Disabilities (DBHDD)
  • Department of Juvenile Justice (DJJ)

3
Who Should Attend
  • Applicants for the Licensing of
  • Child Caring Institution (Group Home, Emergency
    Shelters, Second Chance Homes)
  • Outdoor Child Caring Institutions
  • Child Placing Agency (Foster Care, TFC)

4
Who Should NOT Attend
  • Day Care Center Operators
  • Foster Parent wantabes
  • Adult Personal Care Home Applicants
  • Psychiatric Hospital Applicants
  • Maternity Homes Applicants
  • Insect Exterminators Applicants
  • Beauty Shop Operators Applicants
  • Road Contractors Applicants

5
Overview
  • Normer Adams
  • Executive Director
  • Georgia Association of Homes
  • Services for Children
  • www.gahsc.org
  • normer_at_gahsc.org
  • 404 572 6170

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

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

8
FIRST PRIORITY
  • Develop the
  • BUSINESS PLAN
  • The Plan vs. Good Intentions
  • -Board -Facilities
  • -Budgets -Legal Issues
  • -Constituency -Policies Procedures

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

Needs Assessment
10
FIRST PRIORITY
  • What will I be When I grow Up?
  • Child Placing 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 Institutions Programs
    using a wilderness model for care and treatment
    of children.

Needs Assessment
11
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
12
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
13
FIRST PRIORITY
  • What will I be When I grow Up?
  • Outdoor Child Caring Institutions 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
14
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
  • 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

Needs Assessment
15
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
16
Georgias Priority of Placement
  1. Family
  2. Relative
  3. Adoption
  4. Foster Care public sector
  5. Private sector foster care
  6. Private sector group homes

17
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
18
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
19
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
20
Budgets and Budgeting
  • Medical Care Covered by Medicaid
  • Nearly all children in residential care qualify
    for Medicaid.

Organizational Capacity Assessment
21
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
22
Fundraising
Grants for Startup All Foundations and
Charities 1. 2.3.
Organizational Capacity Assessment
23
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
24
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
25
Your Facilities
  • Fire Inspection - 1 Problem Area
  • Most Expensive to Correct
  • State Regulations, County Interpretations and
    enforcement

Organizational Capacity Assessment
26
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
27
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
28
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
29
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 wont.

30
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
31
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.

Organizational Capacity Assessment
32
Working with the State
  • Some SteerThe State is our partner in caring for
    children. Their role is regulatory and
    contractual. Respect it.
  • Others RowOur role is providing services to
    children. Together we work to provide the best
    care for children.

Organizational Capacity Assessment
33
Budgeting/Rate Setting
  • Truism Child Welfare programming makes for a
    bad business investment.
  • Truism If you are in it for the money, you are
    in it for the money.
  • Georgias 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
34
Budgeting/Rate Setting
  • Truism If you in it for the money, you are in a
    world of trouble. There is no profit in child
    welfare.
  • 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
35
Budgeting/Rate Setting
  • Placement providers are paid a per diem for Room
    and Board and Watchful Oversight.
  • Group Homes
  • Base Additional Maximum
    Oversight
  • 105.69 133.82
    187.64.
  • Child Placing Agency
  • 42.11 57.71
    93.92

Organizational Capacity Assessment
36
Departments Divisions of State Agencies

37
DHS Office of Residential Child CareLicensing
Office of the State
Rhonda James 2 Peachtree St., 32nd
Floor404-657-5589 http//ors.dhr.georgia.gov/port
al/site/DHR-ORS
38
Steps to Provision of Services
  • Step Two - Licensure

39
DHS Office of Residential Child CareResidential
Child Care Licensing
  • License Categories
  • CPA Child Placing Agency - Placement of
    children in foster and or adoptive homes
  • Both domestic and international placement
  • Home Study Services
  • CCI Child Caring Institutions includes
    emergency shelters, group homes, and children's
    homes. 6 or more residents 6-17 years old
  • Medically fragile children
  • OCC Outdoor Child Caring Institution -
    Wilderness Camps
  • Determine the type of program you want to be

Licensure
40
How to Apply for Licensure
  1. All CCIs must obtain local zoning and fire
    approval before submitting an application
  2. Purchase 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
41
Staff Qualificationsfor CCI
  • Director Masters/2 years related experience or
    Bachelors/4 Years 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 must document a satisfactory
    criminal records check

Licensure
42
Staff Qualificationsfor 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
43
Criminal Records Check Law
  • Must be in compliance with Criminal Records
    Checks Law.
  • If employees check reveals any crime, person
    cannot be hired until resolved.
  • Must submit fingerprints to Office of
    Investigative Services for clearance.

Licensure
44
Physical Plant for CCI
  • Water/Sewage
  • Bedrooms63 Square Feet per resident (double
    occupancy. Single 75 Square Feet
  • Bedrooms must document space capacity to serve
    at least six residents
  • 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
45
Behavior Management
  • Develop behavior management policies and
    procedures
  • Policies should address behavior management
    techniques for type of children served
  • Behavior management plan must be documented in
    the residents service plan.

Licensure
46
Behavior Management (continued)
  • The policies address form of discipline that
    shall not be used.
  • Examples
  • - Verbal Abuse, Ridicule or Humiliation
  • - Denial of sleep, shelter or clothing
  • - Corporal punishment

Licensure
47
Behavior Management (contd)
  • Develop policies on emergency safety
    interventions
  • Emergency safety means those behavioral
    interventions techniques that are authorized
    under and an approved emergency safety
    intervention
  • Plans are utilized by properly trained staff in
    an urgent situation to prevent a child from doing
    immediate harm to self or others
  • - List of approved programs attached

Licensure
48
Approved Emergency Prevention Providers
  • Crisis Prevention Institute
  • 3315-H North 124th Street
  • Brookfield, WI 53005
  • Web www.crisisprevention.com
  • 2. Devereux Crisis Intervention (CP/I)
  • 444 Devereux Drive
  • Villanova, PA 19085
  • Web www.devereux.org

49
Approved Emergency Providers Continued
  • 3. Human Empowerment Leadership Principles (HELP)
  • P O BOX 280366
  • Nashville, TN 37228
  • Web www.capscanhelp.com
  • The Mandt System (Mandt)
  • P O BOX 831790
  • Richardson, TX 75083-1790
  • Web www.mandtsystem.com

50
Approved Emergency Providers Continued
  • 5. Professional Crisis Management (PCM)
  • 10273 NW 46th Street
  • Sunrise, FL 33351
  • Web www.pcma.com
  • 6. Safe Crisis Management
  • 36 South Pitt Street
  • Carlisle, PA 17013
  • web www.jkmtraining.com

51
Approved Emergency Providers Continued
  • 7. Therapeutic Aggression Control
  • P O BOX 336
  • 623 N. Main Street
  • Danbury, NC 27016
  • web www.tact2.com
  • 8. Therapeutic Crisis Intervention
  • Family Life Development Center
  • Ithaca, NY 14850
  • web www.rccp.cornell.edu

52
Management of Medications
  • System for Proper Storage, Administration and
    Documentation
  • Monitoring for Side Effects/Complications
  • Expired Medications
  • Accurate Medication Logs (Prescription and
    Non-prescription)
  • Method of Managing Medication Errors
  • Documentation in Service Plan

Licensure
53
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
    Temporary License (12 Months)
  • Annual Re-Licensing Inspections
  • Follow-Up Inspections
  • Complaints/Self-Reported Incidents

Licensure
54
  • B r e a k

55
Steps to Provision of Services
  • Step Three - Contractual Process for Providers

56
  • Division of Family
  • Childrens Services
  • DFCS
  • Provider Relations Unit
  • 404-657-3572
  • http//www.dfcs.dhr.georgia.gov/portal/site/DHR-DF
    CS/

57
Prior to July 1, 2009Department of Human
ResourcesDivision of Family Childrens
Services
  • Provider Relations Unit
  • Phone 404-657-3572 / Fax 404-656-9905
  • 2 Peachtree Street, Suite 18-407
  • http//www.dfcs.dhr.georgia.gov/portal/site/DHR-DF
    CS/
  • Yvonne Rodgers, Program Director - Provider
    Relations

58
Strategic Planning The process by which we
envision our future and develop the necessary
procedures and operations to reach our
destination.
59
Department of Human Services
  • Division of Family and Children Services
  • Provider Relations
  • Phone 404-657-3572 / Fax 404-656-9905
  • 2 Peachtree Street, Suite 18-407
  • http//www.dfcs.dhr.georgia.gov/portal/site/DHR-DF
    CS
  • Point of Contact Yvonne Rodgers

60
Room, Board, and Watchful Oversight
(RBWO)R.B.W.O. is the provision of lodging,
food, and attentive and responsible care to
children.
  • DFCS purchases private placement services for
    children in its custody via
  • Child Caring Institutions
  • Child Placing Agencies
  • Outdoor Therapeutic Camp Programs

61
Characteristics of Children in DFCS Custody
  • Age Birth to 18 years old or older
  • Mental/Emotional/Behavioral Difficulties
  • Medical/Physical Difficulties
  • Deprivation determined by the court
  • Abused, neglected, or abandoned

62
KIDSTAR
  • To view Provider Requirements and Child
    Characteristics please visit
  • www.kidstarga.com

63
Room and Board and Watchful Oversight
  • Child Placing Agencies
  • Traditional RBWO
  • Base RBWO
  • Maximum RBWO
  • Specialty Base Watchful Oversight (SBWO)
  • Specialty Maximum Watchful Oversight (SMWO)
  • Specialty Medically Fragile Watchful Oversight
    (SMFWO)

64
Room and Board and Watchful Oversight
  • Child Caring Institutions
  • Main Program Designations
  • Base
  • Additional Watchful Oversight
  • Maximum Watchful Oversight
  • Categories of Child-based Program Emphasis Within
    CCIs
  • Teen Development
  • Independent Living Program (ILP)
  • 2nd Chance Home
  • Maternity Home
  • Providers shall be responsible for the provision
    or acquisition of services to ensure that each
    childs physical, social, emotional,
    educational/vocational, nutritional,
    spiritual/cultural and permanency needs are met.

65
What do we Want?
  • Placement and support services focused on under
    served populations.
  • Teenagers
  • Sex offending or sexual aggressive
  • Behaviorally disordered children
  • Multiple/Diverse needs
  • Large sibling groups
  • Facilities with expansion ability

66
WHAT WE DO NOT NEED?
  • 8 Bed under Group Homes
  • Base Watchful Oversight Programs
  • Service Providers disconnected from the community
  • Providers with limited diversity in there program
    format and service delivery model

67
DFCS Provider RelationsPre-Application Conference
  • Highly recommended but not required.
  • Preferably face to face.
  • Can include anyone from your core team, staff,
    board, etc.
  • Provider will be expected to present a
    preliminary business plan.
  • Internal team may include Unit Director, Finance
    Director and Regional Supervisor.

68
DFCS Provider Relations Contract Application
Process
  • Prospective Provider requests application package
    from the Provider Relations Unit.
  • Package Includes
  • Application with attachments
  • RBWO Child Characteristics
  • Provider Minimum Requirements

Approval Process of Vendors
69
DFCS Contract Application Process
  • Completed Application is submitted to the
    Provider Relations Unit.
  • Application is reviewed by Provider Relations
    Unit.

Approval Process of Vendors
70
Contract Approval Process
  • Three Possible Outcomes
  • (A) If application accepted, we will review the
    program. Subsequent site visit(s) will be
    scheduled.
  • (B) Application incomplete we will include an
    explanation of application items for which more
    information is needed.
  • (C) Application denied we will include an
    explanation of the basis for the denial.

Approval Process of Vendors
71
Contract Approval Process(continued)
  • If approved to serve children who are in the
    custody of DFCS, a notification letter will be
    sent to the provider and contract process
    initiated.
  • DFCS Provider Relations Unit notifies all county
    DFCS offices of the approval status and
    availability of placement.

Approval Process of Vendors
72
Automatic Denials
  • The following condition will merit the denial of
    a Contract
  • A persons private residence located in a
    licensed facility.
  • Cut doors in a child room to meet fire code.
    Sprinklers are preferred for fire safety.
  • Directors who are qualified by regulation/standard
    s but not accessible to DFCS/DJJ and are not
    accountable to the Board of the agency
  • Staff to child ratios for direct care staff
    should be the same for all shifts. If there is a
    variance, use of sleep staff or a video
    surveillance system to meet staffing requirements
    is unacceptable.

Approval Process of Vendors
73
Referral Process
  • Program may receive referrals directly from
    county DFCS offices, from the Provider Relations
    Unit, other agencies or parental custody with or
    without Department of Behavioral Health
    involvement.

Referrals and Payments
74
(No Transcript)
75
DJJ
  • Department of Juvenile Justice
  • DIVISION OF COMMUNITY CORRECTIONS
  • Community Corrections (404)-657-2431
  • Marie Martin (478) 952-5592
  • www.djj.georgia.gov

76
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
77
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
78
DJJ Districts and Regions
79
Residential Placement Specialists
  • 5 DJJ Regions
  • match DHR Regions
  • Regional Placement Specialists
  • 1. Wayne Reynolds
  • 2. Kim Settles
  • 3. Angela Parker
  • 4. Carl Harrison
  • 5. Sue Riner

Approval Process of Vendors
80
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
81
Characteristics of Children in DJJs 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
82
Services to Children in DJJs Care
  • During FY 2004, 59,000 youth were served by the
    Department of Juvenile Justice.

Services Purchased
83
Private Placements
  • Normer Adams, GAHSC

84
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
85
Characteristics of Children in Private Placement
  • Determined by agencys mission and ability to
    care for the child.
  • And Agencys ability to serve

Characteristics of Children
86
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
87
Private PlacementsReferrals 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
88
Private PlacementsReferrals and Payments
  • Most Private Placements are done on a charity
    basis unless the placement is done by another
    State.

Referrals and Payments
89
In ConclusionSteps 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
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