Statewide Access to Safe and Appropriate Placements Governor’s Action Group for Safe Children...

Statewide Access to Safe and Statewide Access to Safe and Appropriate PlacementsAppropriate Placements

Governor’s Action Group for Safe Children

Draft Recommendations for Discussion

Governor’s Action Group for Safe ChildrenGovernor’s Action Group for Safe ChildrenWork Group # 2: Statewide Access to Safe Work Group # 2: Statewide Access to Safe

and Appropriate Placementsand Appropriate Placements

• Inventory existing placement options• Use existing data and best practice to

define gaps in continuum of placement options

• Consider existing child profile data to prioritize highest system need for placement options

Inventory of Placement OptionsInventory of Placement Options&&

Priorities ofPriorities ofHighest System NeedsHighest System Needs

Priority #1: Quality Foster Priority #1: Quality Foster Care, including family- and Care, including family- and

group-based caregroup-based care



• Address process issues – Image, Marketing, Support, Per Diem, Community Involvement

Foster Homes: Current Number of Homes by DHR Regions/DJJ Districts

397 284

1023

240

245

265

191

312

184

325

223 219Source: Department of

Juvenile Justice, Division of Family and Children

Services, Office of Regulatory Services; May

2002

1 397

2 284

3 1023

4 245

5 240

6 265

7 191

8 312

9 184

10 223

11 219

12 325

Total 3908

Group Homes: Capacity by DHR Regions/DJJ Districts

79 153

812

123

165

247

16

41

224

198

52 44

Source: GA Department of Juvenile Justice,

GAHSC Database; May 2002

1 79

2 153

3 812

4 165

5 123

6 247

7 16

8 41

9 224

10 52

11 44

12 198

Total 2154

Elements ofElements ofQuality Foster CareQuality Foster Care

• Foster homes with higher standards

• Sibling placements

• Therapeutic foster homes

• Kinship care

Determining Need for Quality Determining Need for Quality Foster Care, includingFoster Care, including

family- and group-based carefamily- and group-based care

• According to DFCS: • In FY 1999 Georgia had 5,000 Foster Homes • In FY 2000, Georgia had 4,000 Foster Homes• In FY 2001, Georgia had 3,800 Foster Home

• The number of children in foster care has increased from 12,693 in FY 1999 to 13,965 in FY 2001.

• This decrease in the number of Foster Homes and the increase in the number of children in foster care has created significant pressure on current foster homes due to overcrowding and shortage of appropriate foster home placements.

Determining Need for Quality Determining Need for Quality Foster Care, includingFoster Care, including




• At least 1,200 additional quality foster homes needed statewide

Priority #2: Priority #2: Therapeutic Placements – Therapeutic Placements – Intermediate and Intensive, Intermediate and Intensive, including family, group and including family, group and

residential settingsresidential settings

Alcohol & Drug/Substance Abuse Residential: Capacity by DHR Regions/DJJ Districts

54

15

1515

15

15

15

Source: GA. Division of MHMRSA and GAHSC

Database. May 2002

1 15

2 0

3 54

4 15

5 0

6 0

7 0

8 15

9 15

10 15

11 0

12 15

Total 144

Outdoor Therapeutic Programs: Capacity by DHR Regions/DJJ Districts

60

85

25

50

50

30

30

30

Source: GAHSC DatabaseMay 2002

1 85

2 110

3 0

4 75

5 0

6 0

7 0

8 0

9 60

10 30

11 0

12 0

Total 360

Therapeutic Foster Care: Capacity by DHR Regions/DJJ Districts

6

48

7862

19

8

8

12

7

19

12

1

9


1 60

2 19

3 154

4 0

5 0

6 0

7 26

8 12

9 0

10 1

11 0

12 17

Total 289

Therapeutic Group Homes: Capacity by DHR Regions/DJJ Districts

12

?

246

68

48

10

6

52

12

6

50

150

4010


1 48+

2 0

3 116

4 50

5 0

6 150

7 6

8 62

9 0

10 52

11 10

12 0

Total 494+

Long-Term Psychiatric Hospitals: Capacity by DHR Regions/DJJ Districts 104

100

100

12561

6020

21


1 121

2 0

3 390

4 0

5 0

6 0

7 0

8 80

9 0

10 0

11 0

12 0

Total 591

Elements of Needed Elements of Needed Therapeutic PlacementsTherapeutic Placements

• Acute Emergency Placements • Emergency Shelter Placements• Facilities for dually diagnosed kids

MR/SED• Substance Abuse Programs• Mental Illness with Chronic Violent

Behavior• Sex Offenders’ programs and programs

for victims of sexual abuse

More Elements of Needed More Elements of Needed Therapeutic PlacementsTherapeutic Placements

• Facilities and placements for medically fragile (HIV+)

Placement alternative for kids under 12 – otherwise committed to DJJ

• Therapeutic transitional living programs for DJJ and DFCS children served by MATCH

Determining Need for Therapeutic Determining Need for Therapeutic PlacementsPlacements

• Children currently on state MATCH waiting list 282

• Amy Hale, MATCH Team, DFCS

• Need for MATCH level therapeutic emergency placements 95

• Dianne Sacks, MATCH Team, DFCS

• Estimate of county MATCH, not referred to state level 300

• Amy Hale, MATCH Team, DFCS

• DJJ need for long-term therapeutic placements[1] 100

Cheryl Dresser, Assistant Deputy Commissioner, DJJ

[1] Based on DJJ database, number of youth scoring high on mental health

needs minus youth currently in intermediate and intensive placements.

• DJJ need for emergency therapeutic placements[2] 50

Cheryl Dresser, Assistant Deputy Commissioner, DJJ

• Level of care children (20% of 998 total approved) not able to be placed appropriately because placement is not available 200

2] Based on number of referrals to the State DJJ Behavioral Health

committee - youth in RYDCs and YDCs needing immediate mental health residential placements.

• At least 1,450 additional therapeutic placements needed statewide

Priority #2: Priority #2: Therapeutic Placements – Therapeutic Placements – Intermediate and Intensive, Intermediate and Intensive, including family, group and including family, group and

residential settingsresidential settings

Priority # 3 Priority # 3 Transitional/Independent Living Transitional/Independent Living

ProgramsPrograms

Descriptors of Needed Descriptors of Needed Transitional/Independent Living Transitional/Independent Living

ProgramsPrograms

• Placement options for pregnant teens and teen moms with kids

• Transitional living with vocational/educational supports for state supported children and youth adults

Maternity Homes: Capacity by DHR Regions/DJJ Districts

15

?

8

6


1 0

2 0

3 15+

4 6

5 0

6 8

7 0

8 0

9 0

10 0

11 0

12 0

Total 29+

Second Chance Homes:Capacity by DHR Regions/DJJ Districts

14

8

12

12

12

Source: GA Office of Regulatory Services. May 2002

1 12

2 14

3 8

4 12

5 0

6 0

7 0

8 12

9 0

10 0

11 0

12 0

Total 58

Determining Need for Transitional/Independent Living

Placements

• # in DJJ (non-MATCH) who need transitional living programs [1] 120 Cheryl Dresser, Assistant Deputy Commissioner, DJJ

[1] Based on number of DJJ committed youth scoring high on residential support needs and age 17 or older

Priority # 3 Priority # 3 Transitional/Independent Living Transitional/Independent Living

ProgramsPrograms

• At least 120 transitional living placements needed statewide

Priority # 4:Priority # 4:Emergency Placements, including Emergency Placements, including

family- andfamily- andgroup-based caregroup-based care

Emergency Shelters: Capacity by DHR Regions/DJJ Districts

2287

13

32 67

20

20 12

10

20

52

Source: GAHSC Database. May 2002

1 45

2 12

3 228

4 0

5 22

6 0

7 0

8 10

9 0

10 8

11 20

12 52

Total 397

10

12

8

12

Determining Need for Emergency Placements

• Emergency placements for DJJ “low-“ and “medium-risk” 146 children[1] Cheryl Dresser, Assistant Deputy Commissioner, DJJ

[1] Based on 5% of the total number of youth in FY02 scoring

low or medium on the detention risk assessment instrument (11,689) and turnover every 90 days) The 5% is an estimate of the number that may need emergency shelter care.

• Emergency placements for DFCS “at-risk” children 100

Dianne Sacks, MATCH Team, DFCS

There are currently no available emergency placements in Regions 4,6,7,9, and 10.

Priority # 4:Priority # 4:Emergency Placements, including Emergency Placements, including


• At least 246 emergency placements needed statewide

Summary of Georgia’s Placement Summary of Georgia’s Placement Need Priorities for Year OneNeed Priorities for Year One

1. At least 1,200 additional quality foster care homes statewide

2. At least 1,450 additional therapeutic placements statewide

3. At least 120 additional transitional living placements statewide

4. At least 246 additional emergency placements statewide

YDC:Capacity by DHR Regions/DJJ Districts

410

168

150

244

150

150 349

120

80

Source: GA Department of Juvenile Justice. May 2002

1 0

2 0

3 0

4 0

5 0

6 560

7 394

8 150

9 517

10 120

11 0

12 80

Total 1821

RYDC: Capacity by DHR Regions/DJJ Districts

30

30

100

80

60

64200

49

30

26

40

30

30

30

3030

3030

30

30

100

Source: GA Department of Juvenile Justice. May 2002

1 160

2 80

3 423

4 30

5 26

6 40

7 60

8 30

9 60

10 90

11 30

12 100

Total 1129

50

How do we Change the How do we Change the System??System??

Filling the gaps doesn’t solve the problem

Filling the gaps doesn’t solve the problem

YourHealthPlan

Where Do I Go for HelpHelp?Your

MHPlan

Your

DJJ

Plan

YourDFCSPlan

YourEducationPlan

Multiple Case PlansMultiple Case PlansEducation

??

PublicHealth

MentalHealthDJJ

DFCS

One Case PlanOne Case Plan

MH/MR/SAEducationBehaviorPhysical HealthFamily Support/PreservationPlacement

Services Services AsAs Needed Needed

Services Services WhereWhere Needed Needed

HomeFosterCare

Group Home

InstitutionTherapeutic Foster Care

Therapeutic Residential Placement

Guiding FrameworkGuiding Framework

Case ManagementCase Management

Investigate the optimum case Investigate the optimum case management system that has the management system that has the

following attributes:following attributes: a. Accessibility for all Concerned Parties

b. Accessibility Without Stigma

c. Coordination

d. Research Based

e. Accountability


following attributes:following attributes: f. Multi-Agency Assessment- Single Case

Plan

g. Case Load

h. Interactive Data Systems

i. Community or School Based

j. Judicial Actions


following attributes:following attributes:

k. Funding

l. Competent, Customer/Family Case Managers

m. Involvement

n. Authority for Juvenile Court

o. Community Planning


following attributes:following attributes:

p. Experienced, Educated, Trained and Motivated Case Mangers

q. CWLA Standards

r. Treatment Plans and Outcome Reviews

s. Outcome Measures

t. Responsibility

RecommendationRecommendation

Investigate and develop a case management system with the essential elements by

December 2002.

Governor’s Action Group for Safe ChildrenGovernor’s Action Group for Safe ChildrenWork Group # 2: Statewide Access to Safe and Work Group # 2: Statewide Access to Safe and

Appropriate PlacementsAppropriate Placements

• Inventory existing placement options• Use existing data and best practice to

define gaps in continuum of placement options

• Consider existing child profile data to prioritize highest system need for placement options

Identifiable BarriersIdentifiable Barriers

Legal/Policy Legal/Policy

• All laws, regulations, policies, etc. that define the age of a “child” for the various child serving agencies to determine eligibility for services should reflect a consistent definition and should allow for the provision of services until age 23. This does not intend to initiate services for adults over the age of 18, but rather to guarantee the continuation of services to youth aging out of systems and moving to independent living.

Legal/Policy Legal/Policy

• To assure that disposition is reasonably related to the needs of the child, children who are at risk for out of home placement must have adequate, well-trained legal representation.

• Statutory authority to assess and share information on all children at risk of out-of-home placement will be established.

LicensureLicensure • An independent Office of Regulatory Services,

separate and distinct from the structure, will be authorized to license all public and private residential and in-home service providers. The separation will legitimize the independence of the licensing authority and require the public agencies and well as private providers operating out-of-home placement facilities to meet the same rigorous standards. The Office of Regulatory Services will also be responsible for all waivers and will maintain current and accurate data on all waivers.

LicensureLicensure

• Licensure will require the timely and accurate support of the placement database.

• State incentives to communities should be created that allow group homes of up to 12 children to be established in areas zoned residential or agricultural.

EducationEducation

• Public education will be responsible for providing all education services to all children regardless of special needs or jurisdictional agency.

Mental Health Mental Health

• Georgia needs a comprehensive system of care for mental health, mental retardation and substance abuse.

• Services need to be available to families in their home and in their community based upon assessed risk factors, not on labels.

• Services must also be available to children immediately upon removal from their homes.

StructureStructure

Investigate the creation of a Structure focused on children’s issues. One such structure might be a Children’s Agency that coordinates all programs and services for children and families with children (families with children include guardian, grandparents and other extended families). The structure will address the following:

StructureStructure

a. Case Management – The coordination of all services to children, regardless of the agency delivering the service

b. Mental Health – All outpatient and inpatient services for children

c. Juvenile Justice – All residential and non-residential programs and services

StructureStructure

d. Child Welfare (Child Protective Services/Foster Care/Adoption/Child Support)

e. Family Support/Preservation

f. Substance Abuse – Services for children only with a link to services for adults with children

StructureStructure

g. Public Health – Child and Adolescent medicine

h. Nutrition – Cutting across education, family support, juvenile justice, etc.

i. Expectant Mother – for minor females and females who have not transitioned to independent living

StructureStructure

j. Developmental Disabilities

k. Education Partnership

l. Coordination/maximization of other services (e.g. Peachcare, Title IV-E, etc.)

Statewide Access to Safe and Appropriate Placements Governor’s Action Group for Safe Children...

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