Georgia DFCS Outcome-Based Permanency Initiative

1. Georgia DFCS Outcome-Based Permanency Initiative A Proposal to Introduce Performance-Based Contracting and Partner for CFSR Success

2. Goals of Project • Improve performance on CFSR outcomes related to reunification and permanency for children in foster care • Broaden the availability of intensive home-based programming across the state • Provide community partners with more opportunities to share in the responsibility and reward of accomplishing critical initiatives • Introduce performance-based concepts through an optional annex to current RBWO contracts

3. Service Array Participants should provide document an array of services to youth and their community-based resource (family,kinship, etc) with a goal of permanency. These services should include, but are not limited to: • Family counseling • Individual counseling • School-based reintegration activities • Crisis intervention services • Case management activities as indicated • Aftercare service coordination as indicated

4. Minimum Standards • All children participating in this program must be approved by the Office of Provider Utilization and Outcomes Management • Complete a social history for all youth and family members associated with the identified placement to ensure the appropriateness of the placement • Develop an individualized unification and permanency plan based on the assessment results and the youth, families and DFCS Case Manager’s input. Each barrier to reunification in the assessment should be addressed in order to ensure safety and successful transition

5. Minimum Standards cont. • Submit copies of the assessment and the developed Permanency Plan to the DFCS Case Manager • Staff to client ratio of no greater than 1:6 with staff possessing a masters degree or bachelors degree plus two years experience working with emotionally troubled youth and their families • Supervisor to staff ratio of no greater than 1:4 with supervisors possessing a masters degree or bachelors degree plus three years working with emotionally troubled youth and their families • A licensed clinical professional must provide consultative oversight to all therapeutic services provided to the family

6. Minimum Standards cont. • 24/7 on-call availability clients • No fewer than three successful over-night home visits must occur prior to permanent step-down • After permanent step-down has occurred there must be a minimum of two face to face visits per week with the youth and family. • Attendance at all court dates related to the client • Participation in all Family Team Meetings • Coordination of monthly visitation with siblings and parents

7. Reporting and Evaluation • Provide a monthly report to the case manager which documents the services provided and outlines progress made and continuing barriers to permanency. • Provide a monthly report to OPUOM which outlines raw data related to the population being served and outlines progress made and continuing barriers to reunification. • Services should result in at least 70% of accepted children be placed in a permanent living environment and that 80% of those children remain stable at the six-month anniversary of their discharge from the program. • Outcomes will be tracked by the Provider Utilization and Outcomes Management Unit of DFCS and reviewed with all providers during monthly G meetings.

8. Incentive-Based Payments • Providers are paid performance incentives as they reach certain benchmarks. • Calculation of performance incentives is determined by extended budgeted expenses over expected length of stay and adjusting up for risk. • Averages are based on review of similar programs in other states. • Based on anticipated average expenses of $72.50 per day. • Expected length of participation in the program is contingent upon the anticipated barriers to reunification. Older children with longer lengths of care will be given greater consideration with respect to risk.

9. Option 1 Children 13+ years of age who have been in custody 24+ months 5 mos transition work = $11,020 6 mos post transition work = $13,224 3 mos post discharge tracking =$1,200 ________________________________________________ Total cost per case---------------$25,444 Include 35% risk adjustment brings total possible revenue per case to $34,349.

10. Option 2 All children not meeting option 1 criteria 3 mos transition work = $6,612 5 mos post transition work = $11,020 3 mos post discharge tracking =$1,200 ________________________________________________ Total cost per case---------------$19,014 Include 30% risk adjustment brings total possible revenue per case to $24,718

11. Performance Benchmarks Providers are paid performance incentives as they reach benchmarks along a timeline. Once a benchmark is reached a performance incentive is awarded for that achievement. The awarded revenue is retained even if progress stalls or Regression occurs. The benchmarks are as follows: • Payment 1 – Step-down to permanent placement (enrollment in school, parental supervision and safety plan submitted) • Payment 2 – Discharge (school or vocational attendance 80% of the time during the past 30 days, zero incidents of serious physical aggression in the last 30 days) • Payment 3 – 90 days post-discharge

12. Payment Schedule Option 2 • Payment 1 - $7,000 • Payment 2 – $12,000 • Payment 3 - $6,000 _______________________ Total-------------- $25,000 Option 1 • Payment 1 - $12,000 • Payment 2 – $14,000 • Payment 3 - $9,000 _______________________ Total---------------$35,000

13. Discussion Questions?