New Provider Residential Services Orientation State of Georgia.

New ProviderResidential Services

Orientation

State of Georgia

IntroductionWhat 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 AttendApplicants 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

OverviewNormer Adams

Executive DirectorGeorgia Association of Homes

& Services for Children

www.gahsc.org

[email protected]

404.572.6170

1. Organizational Capacity and Needs Assessments

2. Licensure

3. Contracting with the State

4. Referrals and Payments

Steps to Provision of ServicesPresentation Organization

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 -Legal Issues

-Constituency -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


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


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


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

Georgia’s Priority of Placement


1. Family2. Relative3. Friend4. Adoption5. Foster Care – public sector6. Private sector foster care7. Private sector group homes

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


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


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


Budgets and Budgeting

Medical Care Covered by Medicaid –

Nearly all children in residential care qualify for Medicaid.


Fundraising

Grants for Startup

List of all the Foundations and Charities that give to new organizations starting children homes and group homes.



FundraisingGrants for Startup

All 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


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


Your Facilities

• Fire Inspection - # 1 Problem Area– Most Expensive to Correct– State Regulations, County Interpretations and

enforcement


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


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


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


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?”


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.


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.


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.



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!)



Placement providers are paid a per diem for Room and Board and Watchful Oversight.

CCIs - Group Homes Base $101.82AWO $128.98MWO $181.842nd Chance $162.91Teen Development $108.21Maternity home $101.82




CPAs – Child Placing Agencies (Fixed Payment to Agency)

Traditional $21.44Base WO $29.02

Max WO $40.07SBWO $45.00SMWO $69.00SMFWO $81.00




CPAs – Child Placing Agencies (Payment to Foster Parent based on age of child)

0-5 years of age $14.606-12 years of age $16.5013+ years of age $18.80

Departments & Divisions of State Agencies

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 ValuesVision

Stronger Families for a Stronger Georgia.

MissionStrengthen 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.

http://www.ors.dhr.georgia.gov/

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 2-years 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’ long-term 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.

B r e a k

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 ValuesVision

Stronger Families for a Stronger Georgia.

MissionStrengthen 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


• 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


• 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)

http://www.gascore.com/


• 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


• 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


After reviewing the New ProviderApplication Process Information online,

interested providers with questionsshould contact:

The Office of Provider ManagementMain 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

DJJDepartment of Juvenile Justice

DIVISION OF COMMUNITY Services and Intake

Community Services and Intake (404)-508-6500

www.djj.state.ga.us

· 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.


DJJ Contract Application Process

DJJ Districts and Regions

Residential Placement Specialists

4 DJJ Regions - NW, NE, SW, SE

Regional Placement Specialists1. 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)


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


• 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

Characteristics of 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

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 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

• Determined by agency’s mission and ability to care for the child.

• And Agency’s ability to serve

Characteristics of Children

Characteristics of Children in Private Placement

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 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

Private PlacementsReferrals and Payments

Most Private Placements are done on a charity basis unless the placement is done by another State.

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

In Conclusion:Steps to Provision of Services

New Provider Residential Services Orientation State of Georgia.

Documents

Transcript of New Provider Residential Services Orientation State of Georgia.