+New Provider Residential Services Orientation

1. +New ProviderResidential Services Orientation State of Georgia Orientation

2. Introduction • What We Will Do - Educate • Presented By • Georgia Association of Homes & Services for Children (GAHSC) • Department of Human Services (DHS) • Office of Residential Child Care (ORCC) • Division of Family and Children Services (DFCS) • Department of Juvenile Justice (DJJ)

3. Who Should Attend Applicants for the Licensing of: Child Caring Institution – (Group Homes, Second Chance Homes) Outdoor Child Caring Programs Child Placing Agency (Foster Care, Adoptions) Children Transition Care Centers (CTCC) Orientation

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 Orientation

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 -Legal Issues -Constituency -Policies & Procedures Organizational Capacity Assessement

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

10. What will I be When I grow Up? 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. Outdoor Child Caring Programs – Programs using a wilderness model for care and treatment of children. FIRST PRIORITY Needs Assessment

11. What will I be When I grow Up? 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. Lowest cost per day per child Regulations require that they be not-for-profit. You can not own them, profit from them or sell them. FIRST PRIORITY Needs Assessment

12. What will I be When I grow Up? 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. DFCS is not issuing any new contracts for this service Only 14% of all foster children are placed in these facilities. FIRST PRIORITY Needs Assessment

13. What will I be When I grow Up? 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. FIRST PRIORITY Needs Assessment

14. Child Placing/ Foster Care Private Family centered Child Care Few Capital Costs Labor Cost follow Labor needs Higher Reimbursement to Cost ratio Higher Percentage of children entering care Child Caring Institution / Group Homes Campus focused Child Care High Capital Costs Labor cost do not follow labor needs Lower Reimbursement to Cost ratio Lower percentage of children entering care FIRST PRIORITY What License should I get? Needs Assessment

15. Board Development(Not-for-Profit Only) Should you be a Not-for-Profit (501 c 3)? Organizational Capacity Assessment

16. Georgia’s Priority of Placement Organizational Capacity Assessment

17. 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

18. 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

19. 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 BudgetingBudget Development Organizational Capacity Assessment

20. Budgets and Budgeting Medical Care Covered by Medicaid – Nearly all children in residential care qualify for Medicaid. Organizational Capacity Assessment

21. 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

22. Fundraising Grants for Startup All Foundations and Charities: 1. 2.3. Organizational Capacity Assessment

23. 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

24. 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

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

26. Your Facilities Truism- If Community Support starts off negative, walk away. It will never turn positive. • Community Support - # 2 Problem Area • Build Support Carefully • If negative, hard to overcome • Use community leaders to lead Organizational Capacity Assessment

27. Your Facilities Zoning – The “Tip Off” to the Community -- 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

28. Policies & Procedures(Provides the why and how of the organization) Truism – If your director can not explain them, they should not be your director. • 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

29. Technical & Clinical Assistance(Gut instinct is not enough.) Truism – Education and 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.

30. 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

31. Reporting Requirements Truism – God Forgives but the State never Forgets • 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

32. 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

33. Budgeting/Rate Setting Truism – Child Welfare programming makes for a bad business investment. Georgia’s regulations prohibit any organization from making money. Your daily per diem will be the lesser of your costs or the maximum rate. Organizational Capacity Assessment

34. Budgeting/Rate Setting Truism – If you are doing it for the kids, then the money will come. • Funding remains the top priority for any administrator! • Without money, nothing happens. • The State is your number # 1 customer, and quite often, your only customer! • In Georgia, there are only a hand full of For-Profit agencies. (There is a reason for this. There is no profit in child welfare!) Organizational Capacity Assessment

35. Budgeting/Rate Setting Placement providers are paid a per diem for Room and Board and Watchful Oversight. Group Homes Base Additional Maximum Oversight $105.69 $133.82 $187.64. Child Placing Agency $42.11 $57.71 $93.92 Organizational Capacity Assessment

36. Departments & Divisions of State Agencies

37. DHS Office of Residential Child CareChild Care Licensing Rhonda James (rjames@dhr.state.ga.us) #2 Peachtree Street, Atlanta, GA 30303 404-657-5589 http://ors.dhr.georgia.gov/portal/site/DHR-ORS

38. Steps to Provision of Services Step Two - Licensure

39. DHR Office of Regulatory ServicesChild Care Licensing • License Categories: • CPA – Child Placing Agency - Placement of children in foster and or adoptive homes; domestic and international placement and home Study Services. • CCI – Child Caring Institutions or group homes 6 or more residents 6-18 years old. • CTCC-Children’s Transition Care Center—medically fragile children. Short-Term (1-14 days); Long-Term (90-days) • OCCP – Outdoor Child Caring Program - Wilderness Camps • Maternity Homes (MATH)—home for pregnant mothers. • Determine which type of program you want to be. Licensure

40. How to Apply for Licensure • All CCIs & CTCCs MATH must obtain local zoning and fire approval before submitting an application • Download the licensure application package • Familiarize yourself with ORS rules and regulations--develop a working knowledge of the meaning and intent of these rules and regulations • Develop policies and procedures to address each rule • Prepare your agency for compliance with the regulations Licensure

41. Staff Qualificationsfor CCI • Director: Masters/2 years related experience or Bachelors/4 Years related experience • Human Services Professional (Social Services): Bachelors/2 Years Experience or supervised by Masters • Child Care Worker: 21 Years Old/ High School or GED • Director and owner both must document a satisfactory criminal records check. Licensure

42. Staff Qualificationsfor CPA • Director: Bachelors/2 Years related experience unless doing clinical supervision of staff • Case Work Supervisor (Social Services): Qualified Masters/2 Years CPA experience • Case Worker: Bachelors degree • Director and Owner must document a satisfactory criminal records check Licensure

43. Staff Qualifications for CTCC • Director: Master’s Degree or Higher in Nursing, Social Work or other Health Related field plus two years of experience working with medically fragile children; or • A licensed registered nurse, physician, other licensed health care professional with at least five years of experience working with medically fragile children. Licensure

44. Staff Qualificationsfor CTCC (cont.) • Human Services Professional: • Bachelors Degree in social work with • two years experience or a master’s • degree or be a licensed LPN or • registered nurse. • There shall be one awake RN or other • staff on duty at all times when children • are present who is trained in first aid and • has a current CPR certificate. Licensure

45. Criminal Records Check Law • Must be in compliance with Criminal • Records Checks Law. • If employee’s check reveals any crime, • person cannot be hired until resolved. • Must submit Live Scan and application • to Office of Investigative Services • for clearance. Licensure

46. Physical Plant for CCI • Water/Sewage • Bedrooms:63 Square Feet per resident (double occupancy). 75 Square Feet (Single) • Bedrooms – must document space capacity to serve at least six residents. Not to exceed 16 • Bathrooms – one sink/toilet per 8 kids, 1 shower per 10 kids. • Separate bathroom for staff. • Staff may not enter into a resident bedroom to access the bathroom. • SAFETY FIRST--Inside and Outside Licensure

47. Physical Plant for CCTC • Water/Sewage • Bedrooms: 63 Square Feet per resident (double occupancy). 75 Square Feet (Single) • Bedrooms – must document space capacity to serve at least six residents • Bathrooms – one sink/toilet per 6 kids. • 1 shower per 6 residents. • Separate bathroom for staff. • Staff may not enter into a resident bedroom to access the bathroom. Licensure

48. PHYSICAL PLANT CCTC (CONT) • All centers serving a child or children dependent on a wheel chair or other device for mobility shall have: • At least two exits, remote from each other, accessible to child with easily negotiable ramps. • All doorways and halls shall accommodate wheelchair access. • At least one bathroom of sufficient size to accommodate a wheelchair and assisting staff.

49. Behavior Management • Develop behavior management policies and procedures. • Policies should address behavior management techniques for type of children served. • A behavior management plan must be documented in the resident’s service plan.

50. Behavior Management (cont’d) • Develop policies and procedures on emergency safety interventions • Emergency safety means those behavioral interventions techniques that are authorized under and an approved emergency safety intervention • ESI’s are to only be utilized by properly trained staff in an urgent situation to prevent a child from doing immediate harm to self or others.