New Provider Residential Services Orientation

Who Should Attend Applicants 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

1. Organizational Capacity and Needs Assessments 2. Licensure 3. Contracting with the State 4. Referrals and Payments Steps to Provision of ServicesPresentation Organization

www.gahsc.org ♦ office@gahsc.org ♦ 404.572.6170 Organizational Capacity and Assessment of Needs

Perspective:How Children/Youth Come into Care

Perspective: Characteristics of Children in Care DFCS Room Board and Watchful Oversight Base / Traditional care Base with Additional Watchful Oversight Base with Maximum Watchful Oversight Specialty Base Watchful Oversight Specialty Maximum Watchful Oversight Specialty Medically Fragile Watchful Oversight https://www.gascore.com/content/page.cfm/12/out_of_home_care

Perspective: Georgia’s Priorities

Perspective: Georgia’s Preferred Out-of-Home Placement Hierarchy In-Home with Bio Family Relative Kinship Care Foster Care Group Homes

Perspective: Federal Review Oversight • Permanency • Safety • Well-being

Research Service Needs Licensure does not ensure a contract or placement of children https://www.gascore.com/content/sitemap.cfm

Matching Needs with Services Child PlacingAgency– 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

Matching Needs with Services 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. Per Diem determined by level (basic to therapeutic) Generally lowest paid per day per child rates.

Matching Needs with Services 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. Only 14% of all foster children are placed in these facilities.

Matching Needs with Services 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.

Matching Needs with ServicesWhat License should I pursue? Child Placing Agency (CPA)(Foster Care) Private Family centered Child Care Few Capital Costs Higher Reimbursement to Cost ratio Higher Percentage of children entering care Required to be “not-for-profit” Child Caring Institution (CCI) (Group Homes) Campus focused Child Care High Capital Costs Lower Reimbursement to Cost ratio Lower percentage of children entering care No requirement for “not-for-profit.”

Develop the “BUSINESS PLAN” The Plan versus Good Intentions -Board -Facilities -Budgets -Legal Issues -Constituency -Policies & Procedures Is there a need for the service you are wanting to provide in the geographical area you are wanting to operate?

Board Development(Not-for-Profit Only) Should you be a Not-for-Profit (501 c 3)?

Board Development(Those who are accountable for the organization) Truism - An organization is as strong as its Board. Choose people who can provide expertise in a variety of areas (finance, marketing, social services). Go beyond friends and family (choose people who will provide open and honest feedback) Valued stakeholder in community

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

Executive Director(One who manages the organization) Choose person of experience, integrity, responsibility and history Balance of vision-focus and business Remember he/she will represent your organization They will be held accountable to carry out your policies and procedures

Staff & Personnel (Your most valuable asset/liability) Truism - Your program is as good as your weakest link. A thorough background check is essential. “Would you let these folks care for your child?”

Budgets and BudgetingBudget 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.

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight (RBWO) CCIs - Group Homes Base $104.87 AWO $132.85 MWO $187.30 Maternity home $104.87 *Second Chance $104.87 Teen Development $111.46*plus $62.97 for the infant, total of $167.69

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight (RBWO) CPAs – Child Placing Agencies (Fixed Payment to Agency – excludes payment to foster parent) Traditional $22.08 Base WO $29.89 Max WO $41.27 SBWO $46.35 SMWO $71.07 SMFWO $83.43

Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight (RBWO) CPAs – Child Placing Agencies (Payment to Foster Parent based on age of child) 0-5 years of age $15.04 6-12 years of age $17.00 13+ years of age $19.36

Budgeting/Rate Setting Truism – Quality care resulting in good outcomes will be your best option for success Securing adequate funding remains one of the top priorities for any administrator. Without money, services can not happen. The State is usually your #1 customer/payer In Georgia there are only a handful of For-Profit agencies

Fundraising Grants for Startup Very few Often only to Existing Groups Need 501(c)(3) status – Not-for-Profit Anticipate 18 months for start up support Build constituency

Policies & Procedures(Provides the why and how of the organization) Develop P&P around licensing and contract rules and regulations. Consult someone who has successfully done residential child care. They should make sense to all who must operationalize them. Train on them. Follow your P&P in all ways at all times. Keep them current.

Your Facilities (CCI) Fire Inspection - # 1 Problem Area Most Expensive to Correct State Regulations, County Interpretations and Enforcement

Your Facilities (CCI) Community Support - # 2 Problem Area Build Support Carefully If negative, hard to overcome Use community leaders to lead Truism- Work hard to overcome “not in my backyard” mindset

Your Facilities (CCI) Zoning – The “Tip Off” to the Community -- Required before Licensing-- Zone for “a licensed childcare institution for six or more unrelated children”-- Key Stakeholder of community can help with this

Reporting Requirements Child Abuse Reporting Requirements Stuff will happen - Self-report The law requires you to report abuse and neglect Always report, even if not certain of issue. Preserve your relationship with State by dealing with integrity

Additional Considerationto Delivery of Services Performance Based Placement Deliverables and Outcomes Data Management, Documentation and Reporting Competition Experience Accreditation

Oversight Residential Child Care (licensing) Office of Provider Management (DFCS contract) PEAS Kenny A (Fulton and DeKalb Counties) 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. Working with the State

Departments & Divisions of State Agencies

Step Two - Licensure Steps to Provision of Services:

New Provider Orientation Presenter: Rhonda James, DHS—Office of the Inspector General, Residential Child Care Unit Presentation to: GAHSC New Provider Orientation Date: Quarterly (2nd Tuesday of the Month) Georgia Department of Human Services

Vision, Mission and Core Values Vision Stronger Families for a Stronger Georgia. Mission Strengthen 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 @ https://dhs.georgia.gov/forms-and-applications • 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.

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.

New Provider Residential Services Orientation