+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 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)

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

4. Who Should NOT Attend Day Care Center Operators Foster Parent wantabe’s Adult Personal Care Home Applicants Psychiatric Hospital Applicants Maternity Homes ApplicantsInsect 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@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 • Constituency -Policies & Procedures Needs Assessment

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

10. 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

11. 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

12. 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

13. Budgets and Budgeting Budget DevelopmentExpensesIncome • State Fees • Contributions • Grants • Endowments Organizational Capacity Assessment

14. Budgets and Budgeting Medical CareCovered by Medicaid - Nearly all children in residential care qualify for Medicaid. Organizational Capacity Assessment

15. Budgets and Budgeting • 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 dues Organizational Capacity Assessment

16. 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

17. Fundraising Grants for StartupAll Foundations and Charities 1. 2.3. Organizational Capacity Assessment

18. 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

19. 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

20. Your Facilities • Fire Inspection - # 1 Problem Area • Most Expensive to Correct • State Regulations, County Interpretations and enforcement Organizational Capacity Assessment

21. Your Facilities • Community Support - # 2 Problem Area • Build Support Carefully • If negative, hard to overcome • Use community leaders to lead Organizational Capacity Assessment

22. 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

23. 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

24. 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.

25. 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

26. 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

27. 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

28. Budgeting/Rate Setting • Funding remains the top priority for any administrator! • The State is your number # 1 customer, and quite often, your only customer! • In Georgia, there are only a handful of For-Profit agencies. Reason - There is no money in Child Welfare work! Organizational Capacity Assessment

29. LOC Descriptions • Level of Care is: • Six levels of care provided in both child caring institutions and foster care. • A system of care which matches the needs of the child with appropriate and timely services • Purchases placement services for a child based upon the child’s needs. • Establishes payment rates based upon the levels of care needed by the child. Organizational Capacity Assessment

30. Provider ReportsLevel of Care Requirements • Annual Cost Report and Time Study Required • Description of Treatment Program • Independent Audit Report Organizational Capacity Assessment

31. Departments & Divisions of State Agencies

32. DHR Office of Regulatory ServicesChild Care Licensing #2 Peachtree St., 32nd Floor 404-657-5562

33. Steps to Provision of Services Step Two - Licensure

34. DHR Office of Regulatory ServicesChild Care Licensing • License Categories: • CPA – Child Placing Agency - Placement of children in foster and or adoptive homes • CCI-Child Caring Institutions includes emergency shelters, group homes, and children's homes. • OTP – Outdoor Therapeutic Program - Wilderness Camps Licensure

35. How to Apply for 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

36. Staff Qualificationsfor CCI • 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

37. Staff Qualificationsfor CPA • Director: Bachelors/2 Years experience unless doing clinical supervision of staff • Case Work Supervisor (Social Services): Qualified Masters/2 Years CPA experience • Case Worker: Bachelors degree • Satisfactory criminal records check by contract requirement Licensure

38. Criminal Records Check LawExpected to change 7/1/04 • Must be incompliance with Criminal Records Checks Law. • If employee’s check reveals any crime, person cannot be hired until resolved. Licensure

39. Physical Plant for CCI • 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

40. 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

41. Behavior Management (continued) • Chemical restraints or mechanical restraints • Denial of communication and visits unless restricted in treatment planning process • Corporal punishment Licensure

42. 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

43. Management of 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

44. Regulatory Process • Self-Assess for Rule Compliance and Completed Application Materials • Submit Application with local approvals if required • Initial On-Site Inspection – Office Conference: Temporary License (6 Months) • Annual Re-Licensing Inspections • Follow-Up Inspections • Complaints/Self-Reported Incidents Licensure

45. Break

46. Steps to Provision of Services Step Three - Contractual Process for Providers

47. Linda Ladd Provider Support Unit 404-657-3460 Rosalyn Williams Provider Support Unit 404-657-3574 Division of Family & Children’s Services DFCS

48. Level of Care Services Purchased by DFCS Services purchased by DFCS for children in its custody are provided by the following: • Child Caring Institution • Child Placing Agency • Outdoor Therapeutic Program Services Purchased

49. LOC Services Purchased by DFCS • Level of Care System purchases placement services based upon a child’s needs. There are six levels of care that cover the entire continuum of out of home care provided by the private sector. Services Purchased

50. Characteristics of Children in DFCS Custody • Age • Birth to18 years old • Mental/Emotional/Behavioral Difficulties • Medical/Physical Difficulties • Deprivation determined by the court • Abused, neglected, or abandoned • More Detail can be found in the “Level of Care Indicator Manual” on the web at www.gahsc.org Characteristics of Children