New Provider Residential Services Orientation
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Transcript of New Provider Residential Services Orientation
New ProviderResidential Services
Orientation
State of Georgia
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Marketing
How to sale soap and rule the world.
Introduction• What We Will Do - Educate • Presented By
– Georgia Association of Homes and Services for Children (GAHSC)
– Department of Human Resources (DHR)• Office of Regulatory Services (ORS)• Division of Family and Children Services (DFCS) • Division of Mental Health, Developmental Disabilities
and Addictive Diseases (DMHDDAD)
– Department of Juvenile Justice (DJJ)
Who Should AttendApplicants for the Licensing of:
•Children Group Home •Child Placing Agencies •Therapeutic Group Homes•Outdoor Therapeutic Centers•Emergency Shelters•Foster Care Placing Agencies•Second Chance Homes•Teen Mothers with child homes
Who Should NOT AttendFoster Parent wantabe’s
Adult Personal Care Home Applicants
Psychiatric Hospital Applicants
Maternity Homes ApplicantsInsect Exterminators Applicants
Beauty Shop Operators Applicants
Road Contractors Applicants
OverviewNormer Adams
Executive DirectorGeorgia Association of Homes
& Services for Children
www.gahsc.org
404 572 6170
1. - Organizational Capacity and Needs Assessments
2. - Licensure
3. - Approval Process for Vendors
4. - Referrals and Payments
Steps to Provision of Services
Step one - Organizational Capacity and Needs
Assessments
Steps to Provision of Services
FIRST PRIORITY
Develop the
“BUSINESS PLAN”
The Plan vs. Good Intentions– Board -Facilities – -Budgets– Constituency -Policies & Procedures
Needs Assessment
FIRST PRIORITY
THE BUSINESS PLAN (continued)
• Research– The Need– The Competition
• Interviews• Field Trips
Needs Assessment
SECOND PRIORITY
Develop “YOUR CONSTITUENCY” (Who Supports You)
• Your CommunityChurch, Civic Groups, Interested Parties
• Your SupportersGive Time, Money, and Resources
• Your BoardDeveloped from your Constituency
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- State Fees- Contributions- 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
Budgets and Budgeting(See Handout # 1 – Sample Start-Up Budget)
• Staff--Base Pay
• Benefits
• Insurance--Property, Casualty, & Liability
• Other, including: Food, office supplies, clothing, travel & recreation, medical expenses,
school supplies & activities, gifts, allowances, conference expenses,vehicle repair, fuel, maintenance, grounds, promotions, postage, utilities,telephone, moving expenses of staff, GAHSC membership dues, and legal and professional
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
Organizational Capacity Assessment
FundraisingGrants for StartupAll Foundations and Charities 1.2.3.
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
• Community - # 2 Problem Area– Build Support Carefully– If negative, hard to overcome– Use community leaders to lead
Organizational Capacity Assessment
Your Facilities
Zoning - # 3 Problem Area-- 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)
• 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 - 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.
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
• 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
Working with the State• Some Steer
The 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
Departments & Divisions of State Agencies
Department of Family and Children Services (DFCS)
Budgeting/Rate Setting
Organizational Capacity Assessment
BUDGETING/RATE SETTING
• Family Foster Care
• Institutional Foster Care
Organizational Capacity Assessment
Family Foster Care
DFCS Family Foster Homes Per Diem Rate – $33.30 Per Day – Provider Rate– Level of Care Family Foster Homes (Daily
Per Diem Calculated) for SED children
Organizational Capacity Assessment
Institutional Foster Care(group homes)
PER DIEM RATE
• Currently $44.22 /day/child for new providers.
• After first year reimbursement Rate Calculated at 62% of Total Allowable Costs.
Organizational Capacity Assessment
Allowable Costs (See Handout # 1 – Sample Start-Up Budget)
• Salaries
• Consultation Fees
• Occupancy Costs
• Insurance Costs
• Maintenance & Repair
• Depreciated Equipment
• Consumer Supplies
• Payroll Related Expenses
• Travel• Utilities• Leased Equipment• Purchased
Equipment• Lease Purchase
Organizational Capacity Assessment
Unallowable Costs
• Bad Debt• Contributions &
Donations• Depreciation• Investments• Organizational
Costs
• Contingencies• Entertainment• Fines & Penalties• Prohibited Activities
Organizational Capacity Assessment
Provider ReportsInstitutional Foster Care (IFC)
• Annual Group Facilities Cost Report
• Description of Treatment Program
• Independent Audit Report
• Typical Weekly Schedule
Organizational Capacity Assessment
• Step Two - Licensure
Steps to Provision of Services
DHR Office of Regulatory Services
Child Care Licensing
#2 Peachtree St., 32nd Floor
404-657-5562
DHR Office of Regulatory Services
Child Care Licensing• License Category:
-- CCI-Child Caring Institutions includes emergency shelters, group homes, and children's homes. (6 or more residents in (24 hour care)
• Application Process -- How to apply, temporary licensing, license
Licensure
How to Apply for Licensure(Handout # 2- Steps To Licensure)
• Purchase licensure application package
• Familiarize yourself with ORS rules and regulations--develop a working knowledge of the meaning and intent of these rules and regulations
• Prepare your agency for compliance with the regulations
Licensure
Staff Qualifications
• Director: Masters/2 years 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
• Satisfactory criminal records check
Licensure
Staff Qualifications (continued)
• Human Services Professional--Master’s Degree in social work, psychology, childhood education, education counseling and psychology, or related field ,
• OR a bachelor’s degree in one of these fields and two years experience, or under the supervision of another HSP with a Master’s degree.
Licensure
New Criminal Records Check Law----July 1, 1999
• Satisfactory state fingerprint result on Director, with FBI results pending
• Satisfactory preliminary results--employees
• Employee checks can be done by local law enforcement with results on file
• If employee’s check reveals any crime, person cannot be hired until resolved.
Licensure
Physical Plant(Handout #3- Child Caring Institution Self Assessment for Physical Plant)
• Water/Sewage• Bedrooms: 63 Square Feet per resident
Single: 75 Square Feet
• Bathrooms - one sink /toilet per 8 kids, 1 shower per 10 kids
• Proper Storage for Hazardous Items• SAFETY FIRST--Inside and Outside
Licensure
Behavior Management(Handout #4- Discipline and Behavior Management )
• Forms of discipline which are not allowed
• Excessive or unreasonable work tasks• Denial of meals and hydration• Denial of sleep• Denial of shelter, clothing, or essential
personal needs• Verbal abuse, ridicule, or humiliation
Licensure
Behavior Management (continued)
• Chemical restraints or mechanical restraints
• Denial of communication and visits unless restricted in treatment planning process
• Corporal punishment
Licensure
Specifics on Behavior Management
• Regulations on the use of isolation rooms
• Regulations on the use of physical control techniques--ONLY by staff trained by a certified trainer and documented in personnel record
• Discipline/behavior management methods MUST be documented in the treatment plan
Licensure
Management of Medications(Handout # 5- Medications)
• System for Proper Storage, Administration and Documentation
• Monitoring for Side Effects/Complications
• Expired Medications• Accurate Medication Logs• Method of Managing Medication Errors• Documentation in Treatment Plan
Licensure
Regulatory Process
• Submit Application with local approvals• Self-Assess for Rule Compliance and
Completed Application Materials • Initial On-Site Inspection: Temporary
License (6 Months)• Annual Re-Licensing Inspections• Follow-Up Inspections• Complaints/Self-Reported Incidents
Licensure
Break
Step Three - State Approval Process of Vendors
Steps to Provision of Services
Division of Family
& Children’s Services
DFCSLinda Ladd
Program Consultant,
Treatment Services Unit (MATCH)
404-657-3460
Rosalyn Williams
Program Consultant,
Treatment Services Unit (MATCH)
404-657-3574
Services purchased by DFCS for children in it’s custody are:– Institutional Foster Care (IFC)
– Family Foster Care (FFC)
Services Purchased
Services Purchased by DFCS
• Institutional Foster (IFC) requires license by the Office of Regulatory Services (ORS)
• IFC includes group homes, emergency shelters, child care institutions, and therapeutic camps.
• Family Foster Care (FFC) requires license as Child Placing Agency or Child Caring Institution with Foster Care Services.
Services Purchased by DFCS(Handout 6- Guidelines For Providers)
Services Purchased
54Orientation
Characteristics of Children in DFCS Custody
• Age– Birth to 18 years old
• Mental/Emotional/Behavioral Difficulties• Medical/Physical Difficulties Deprivation
determined by the court• Abused, neglected, or abandoned• Committed status
Characteristics of Children
DFCS Approval Process
(Handout # 7- FCC IFC Provider Approval Memo)
• Potential Provider requests application package from the Treatment Services Unit.
• Completed Application is submitted to the Treatment Services Unit.
• Application is reviewed by Treatment Services Unit.
(Refer To Handout 7a and 7b for IFC Application and FFC Application)
Approval Process of Vendors
Approval Process (continued)
Three Possible Outcomes:
(A) Application accepted--will conduct an on-site visit and review the program
(B) Application incomplete--will include an explanation of application items for which more information is needed
(C) Application denied--will include an explanation of the basis for denial
Approval Process of Vendors
Approval Process (continued)
• If approved to serve children who are in the custody of DFCS, a notification letter will be sent to the provider.
• DFCS Treatment Services Unit notifies all county DFCS offices of the approval status.
Approval Process of Vendors
Referral Process
• Program will receive referrals directly from county DFCS offices.
• County DFCS is responsible for reimbursement for services.
Referrals and Payments
DMHDDADDivision of
Mental Health Developmental Disabilities
and Addictive Diseases
Suzanne LindseyC & A MH Program Specialist
Department Of Human ResourcesDivision Of Family and Children Services
404-657-2136
DMHDDAD
•Division of DHR •Made up of 7 Regional Boards http://www2.state.ga.us/departments/dhr/mhmrsa/regbomp.html
(Handout 8- Regional Executive Directors )
•Contract with 27 Community Services Boards (CSBs) and other private providers
(Handout 9- Community Service Boards)
•CSBs also sub contract with providers
Approval Process of Vendors
DMHDDAD Regions
• SED (Severely Emotionally Disturbed)• Under age of 18• Major mental illness diagnosis, such as
Major Depression, bi-polar disorder, anxiety disorder, PTSD, ADHD, oppositional defiant disorder, and substance abuse disorders
• Many are multi-agency involved
Characteristics of Children
Characteristics of Children in DMHDDAD Care
• Following appropriate licensing from ORS, contact the Regional Board or the Community Service Board (CSB) in your area (see handout material).
• If chosen as an eligible provider, you must comply with all Division standards and provider manual requirements (Regional Boards have this information).
Approval Process of Vendors
DMHDDAD Approval Process
(Handout # 11- DMHDDAD Guidelines for potential C&A Residential Services Providers)
SED Residential TreatmentServices of DMHDDAD
• Highly structured and supervised home• Individual, family, group and activity
therapy services• Psychiatric services, including
medication monitoring by an M.D. (psychiatrist)
• Community Re-integration Services, including identification of natural support systems
Services Purchased
DMHDDAD Referral Process
• Contracts are made directly with Regional Boards or Community Service Boards.
• The Regional Boards or Community Service Boards are responsible for reimbursement for services.
Referrals and Payments
DJJDepartment of Juvenile Justice
DIVISION OF COMMUNITY CORRECTIONS
Gwen Skinner
Deputy Commissioner,
Community Corrections
404-657-2431
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
No Formal, Written Application
Upon Obtaining Licensure, Contact the Residential Placement Specialist (RPS) in the District in which Your Facility is Located
Approval Process of Vendors
DJJ Approval Process (Handout 12- DJJ Procedure for Approval)
State Outline of DJJ Districts
(Handout # 13- DJJ Community Corrections District Lines)
Residential Placement Specialists
(Handout # 14- Community Corrections)
13 Districts
match DHR Districts
Regional Placement Specialists
1. Wayne Reynolds
2. Kim Settles
3. Angela Parker
4. Carl Harrison
5. Sue Riner
Approval Process of Vendors
DJJ Approval Process
• Residential Placement Specialist (RPS) Conducts Site Visit
• Assesses Willingness and Ability to Service Delinquent Youth– School Issues– Supervision
• Contract
Approval Process of Vendors
DJJ Contracts and Payments
• Contract - referrals and payments are negotiated through contracts.
Referrals and Payments
• Average Age - 15 (range is from 8-17)
• 82% Males - 18% Females• Most Common Offenses - Property & Status• Oppositional - Lack Impulse Control• Common Mental Health Diagnoses - Conduct
Disorder, Depression, PTSD• Substance Abuse Issues
Characteristics of Children
Characteristics of Children in DJJ’s Care
• During FY 1998, 789 youth were served in the Contract Home Program.
• Youth were served in either– Group Homes– Private Family Placements
Services Purchased
Services to Children in DJJ’s Care
Private Placements
Normer Adams, GAHSC
Private Placements
Agency determines what services to sell (or give away) to the private individual. The nature of these services are determined on the ability to provide those services within the Licensing framework
Services Purchased
• Characteristics of the children -- Determined by agency according to their mission and ability to care for the child.
• And by ability to serve.
Characteristics of Children
Characteristics of Children in Private Placement
Private Placements
• Application Process-- Licensing allows an agency to provide out of homes services. Within the rules of Licensing, each agency develops their own application process.
• Approval Process -- There is no approval process save Licensure.
Approval Process of Vendors and Marketing
Private PlacementsReferrals and Payments
• Referrals - Referrals are made by private individuals or agencies. This referral network is determined by the agency.
• Payments - Payments are negotiated with each referring party.
Referrals and Payments
MATCH
Multi-Agency Team for Children
• Children have severe mental, emotional and behavioral disturbances.
Characteristics of Children
Characteristics of Child Served by MATCH
MATCH(Multi-Agency Team for Children)
• Includes DFCS, DJJ, DOE, ORS, and DDMHDDAD
• MATCH is responsible for arranging and purchasing residential treatment services for children with mental, emotional and behavioral disturbances.
Approval Process of Vendors
• Intensive Residential Treatment Programs
• Intermediate Residential Treatment Programs
• Outdoor Therapeutic Programs
• Therapeutic Foster Care (Levels I and II)
Services Purchased
MATCH Services Purchased
MATCH Enrollment Process
(Handout 15- MATCH Provider Enrollment Application Memo)
• Potential provider requests application package from the Treatment Services Unit.
• Potential provider must have the appropriate license from ORS.
• The agency must be in compliance with the “Certification Standards for Enrollment as a Provider of Therapeutic Residential Child Care Services” prior to the submission of the completed application to the Treatment Services Unit.
Approval Process of Vendors
MATCH Enrollment Process (continued)
• Completed application is submitted to the Treatment Services Unit.
• Application is reviewed by Treatment Services Unit.
Approval Process of Vendors
MATCH Enrollment Process (continued)
Three Possible Outcomes:
(A) Application accepted--Treatment Services Unit and ORS will conduct an on-site visit and review the program
(B) Application incomplete--will include an explanation of application items for which more information is needed
(C) Application denied--will include an explanation of the basis for denial
Approval Process of Vendors
• If enrolled as a MATCH provider, appropriate paper work, including rate notification and contract with DHR will be sent.
• Program is added to the list of approved MATCH providers.
Referrals and Payments
MATCH Enrollment Process (continued)
MATCH Outcome Project
• A system designed to measure and track the effectiveness and results of residential treatment services provided to children and adolescents with severe emotional disturbance.
• All providers are required to participate.Services Purchased
MATCH Enrollment Process (continued)
• Provider will receive referrals from County DFCS or Community Mental Health after the child has been approved for funding by the State MATCH Committee.
• Approval letter is sent to the MATCH provider.
• The State Office of DHR is responsible for reimbursement for service.
Referrals and Payments
MATCH Referrals and Payments
1. - Organizational Capacity and Needs Assessments
2. - Licensure
3. - State Approval Process for Vendors
4. - Marketing to Referral Sources, DFCS, DJJ, Private Sector
Steps to Provision of Services
WRAP-UP
• Questions????????
• Evaluation Forms (Handout 16- Evaluation)
• Training Certificate
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