New Provider Residential Services Orientation

1. New ProviderResidential Services Orientation State of Georgia

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3. 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)

4. Who Should Attend Applicants 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

5. Who Should NOT Attend Foster Parent wantabe’s Adult Personal Care Home Applicants Psychiatric Hospital Applicants Maternity Homes ApplicantsInsect Exterminators Applicants Beauty Shop Operators Applicants Road Contractors Applicants

6. Overview Normer Adams Executive Director Georgia Association of Homes & Services for Children www.gahsc.org normer@gahsc.org 404 572 6170

7. Steps to Provision of Services 1. - Organizational Capacity and Needs Assessments 2. - Licensure 3. - ApprovalProcess for Vendors 4. - Referrals and Payments

8. Steps to Provision of Services Step one - Organizational Capacity and Needs Assessments

9. FIRST PRIORITY Develop the “BUSINESS PLAN” The Plan vs. Good Intentions • Board -Facilities • -Budgets • Constituency -Policies & Procedures Needs Assessment

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

11. 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

12. 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

13. 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

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

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

16. 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

17. 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

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

19. 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

20. 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

21. 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

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. Departments & Divisions of State Agencies

29. Department of Family and Children Services (DFCS)Budgeting/Rate Setting Organizational Capacity Assessment

30. BUDGETING/RATE SETTING • Family Foster Care • Institutional Foster Care Organizational Capacity Assessment

31. 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

32. 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

33. Salaries Consultation Fees Occupancy Costs Insurance Costs Maintenance & Repair Depreciated Equipment Consumer Supplies Payroll Related Expenses Travel Utilities Leased Equipment Purchased Equipment Lease Purchase Allowable Costs(See Handout # 1 – Sample Start-Up Budget) Organizational Capacity Assessment

34. Bad Debt Contributions & Donations Depreciation Investments Organizational Costs Contingencies Entertainment Fines & Penalties Prohibited Activities Unallowable Costs Organizational Capacity Assessment

35. Provider ReportsInstitutional Foster Care (IFC) • Annual Group Facilities Cost Report • Description of Treatment Program • Independent Audit Report • Typical Weekly Schedule Organizational Capacity Assessment

36. Steps to Provision of Services Step Two - Licensure

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

38. DHR Office of Regulatory ServicesChild 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

39. 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

40. 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

41. 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

42. 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

43. 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

44. 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

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

46. 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

47. 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

48. 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

49. Break

50. Steps to Provision of Services Step Three - State Approval Process of Vendors